Published: 2017-03-30

A correlation of hysterolaparoscopic findings and BACTEC culture in infertility

Mahesweta Guru, Prasad Yeshwant Deshmukh


Background: Infertility is agonising condition. Tuberculosis is an important health problem worldwide. One third of the world’s population is currently affected with tuberculosis. Hysterolaparoscopy is a well-recognized procedure for the diagnosis of infertility. Culture for TB bacilli is the gold standard for diagnosis of genital TB.

Methods: Infertile women undergoing dilatation and curettage with hysterolaparoscopy with normal husband semen analysis as a part of their infertility workup at M. G. M. Medical Hospital, Kalamboli. Sample size: 30.

Results: Incidence of GTB=22.85%, 25-29 year followed by 35-40 years’ age group was the most common age group was observed. In our study, 74.3% infertility pattern was primary, 25.7% were secondary only 2.85 % (n =1) of the cases of GTB were diagnosed by using TB BACTEC. Laparoscopic findings su0ggested that 18 cases had normal findings and 8 cases had laparoscopic features suggestive of GTB. On chromo pertubation, delayed and absent spillage of the dye was seen in 2 cases. On Hysteroscopy, 29 cases (82.9%) of the patients had normal findings and 3 cases had Hysteroscopic features suggestive of GTB.

Conclusions: Genital tuberculosis remains an important under diagnosed cause of infertility. Though culture is considered as gold standard for diagnosis of genital tuberculosis, since GTB is paucibacillary there is an urgent need for more research to come to conclusion whether culture is still gold standard. Further research is required to detect the most sensitive method for diagnosis.


Bactec culture, Genital tuberculosis, Hysterolaparoscopy, Infertility

Full Text:



Jassawalla MJ. Genital Tuberculosis- A Diagnostic Dilemma. J ObstetGynecol India. 2006;56(3):203-4.

Lakshmi V, Patil MA, Subhadha K, Himabindu V. Isolation of Mycobacteria by BACTEC 460 system from clinical specimens. Ind. J Med Micribiology, 2006;24(2):124-6.

Arora VK, Gupta R, Arora R. Female Genital Tuberculosis: Need for More Research. Ind J Tub. 2003;50(9):36-8.

Gatongi DK, Gitau G, Kay V, Ngwenya S, Lafong C, Hasan A. Female genital tuberculosis. ObstetGynaecol. 2005;7:75-9.

Litynski GS. Laparoscopy. The early attempts: spotlighting Georg Kelling and Hans Christian Jacobaeus. Journal of the Society of Laparoendoscopic Surgeons. 1997;1:83-5.

Vecchio R, MacFayden BV, Palazzo F. History of laparoscopic surgery. Panminerva Med. 2000;42(1):87-90.

Advincula AP, Wang K. Evolving role and current state of robotics in minimally invasive gynecologic surgery. J Minim Invasive Gynecol. 2009;16(3):291-301.

Rowe PJ, Comhaire FH, Hargreave TB, Mahmoud AMA. WHO manual for the standardized investigation of the infertile couple. Cambridge, UK: Cambridge University Press Cambridge, UK, 1993.

Forman RG, Robinson JN, Mehta Z, Barlow DH. Patient history as a simple predictor of pelvic pathology in sub fertile women. Hum Reprod.1993;8:53-5.

Balasch J. Investigation of the infertile couple in the era of assisted reproductive technology: A time for reappraisal. Human Reproduction 2000; 15: 2251-57.

Simon A, Laufer N. Unexplained infertility: a reappraisal. Ass Reprod Rev. 1993;3:26-36.

Fayez JA, Mutie G, Schneider PJ. The diagnostic value of hysterosalpingography and laparoscopy in infertility investigation. Int J Fertil. 1988;33:98-101.

Comparative studies between the value of hysterosalpingography and Coelioskopie in sterility diagnosis. Archives of Gynecology and Obstetrics. 1967:204;167-8.

Marc JNC Keirse, Vandervellen R. A comparison of HSG and Laparoscopy in the investigation of infertility. Obstetrics and Gynecology. 1973;41(5):685-8.