Effect of prior anti-tuberculosis treatment on assisted reproductive outcomes in infertile women: a retrospective cohort study.

PURPOSE: Tuberculosis (TB) is a significant factor contributing to infertility. For some infertile patients, chest radiography (CXR) screenings prior to assisted reproductive treatment (ART) reveal old/inactive TB lesions. However, the pregnancy outcomes after ART for such patients who had a history of prior anti-TB treatment remain unclear.

DESIGN: Retrospective cohort study.

SETTING: Peking University Third Hospital, a tertiary care centre.

PARTICIPANTS: This study analysed and focused on infertile patients aged 20-50 years with prior TB lesions on CXR (treated/untreated) and normal CXR. Active TB cases were excluded from this study. Patients were categorised into three groups based on CXR findings and prior anti-TB treatment: treated prior-pulmonary TB (PTB) group, untreated prior-PTB group and a non-PTB control group with normal CXR.

PRIMARY AND SECONDARY OUTCOME MEASURES: ART outcomes, including clinical pregnancy rate, miscarriage rate and live birth rate, were compared among the groups.

FINDINGS TO DATE: Among 8769 patients analysed, including treated prior-PTB group (n=171), untreated prior-PTB group (n=791) and non-PTB group (n=7807). The treated prior-PTB group showed a similar clinical pregnancy rate (41.5% vs 38.1%, p=0.360) and live birth rate (35.3% vs 30.6%, p=0.187) compared with the non-PTB group. The miscarriage rate was slightly lower in the treated prior-PTB group than in the non-PTB group (11.3% vs 15.5%, p=0.325), although the discrepancy was not statistically significant. Compared with the untreated prior-PTB group, the treated prior-PTB group exhibited significantly higher live birth rate (35.3% vs 23.8%, p<0.05), clinical pregnancy rate (41.5% vs 31.7%, p<0.05) and with a lower miscarriage rate (11.3% vs 19.1%, p=0.123), although the latter was not statistically significant. Multivariable regression confirmed significantly higher live birth rates in the treated prior-PTB group versus untreated prior-PTB group (aOR: 1.69, 95%&#x2009;CI: 1.01 to 2.83, p=0.045).

CONCLUSIONS AND FUTURE PLANS: Anti-TB treatment in infertile women with prior PTB lesions was associated with improved ART outcomes, comparable to those in patients without TB lesions. This suggests a potential clinical benefit of anti-TB treatment in improving reproductive outcomes in this population. Further research is warranted to explore ART outcomes in patients with untreated prior TB lesions.