Adverse pregnancy outcomes after in vitro fertilization due to undiagnosed urogenital tuberculosis and proposed screening algorithm for patients from tuberculosis-endemic countries
Stephanie E. McLaughlin, M.D., M.P.H.,
Surabhi B. Vora, M.D.,
E. Chandler Church, M.D., M.Sc.,
Christopher Spitters, M.D.,
Angela Thyer, M.D.,
Sylvia LaCourse, M.D.,
Christopher N. Herndon, M.D.
Affiliations
Stephanie E. McLaughlin, M.D., M.P.H.
Department of Medicine, Division of Infectious Diseases, University of Washington; Public Health Seattle and King County
Surabhi B. Vora, M.D.
Department of Pediatrics, Division of Infectious Diseases, Seattle Children’s Hospital
E. Chandler Church, M.D., M.Sc.
Department of Medicine, Division of Infectious Diseases, University of Washington; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington
Christopher Spitters, M.D.
Department of Medicine, Division of Infectious Diseases, University of Washington; Public Health Seattle and King County; Snohomish Health District
Angela Thyer, M.D.
Seattle Reproductive Medicine
Sylvia LaCourse, M.D.
Department of Medicine, Division of Infectious Diseases, University of Washington; Department of Global Health, University of Washington, Washington
Christopher N. Herndon, M.D.
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington; Reprint requests: Christopher N. Herndon M.D., Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Washington, 1959 NE Pacific Street, Seattle, Washington, 98195-6460.
Objective: To report 2 cases of adverse pregnancy outcomes due to delayed diagnosis of urogenital tuberculosis and propose a screening algorithm for patients from tuberculosis-endemic countries. Design: Case report. Setting: Academic medical center. Patient(s): Two patients with delayed diagnosis of urogenital tuberculosis leading to a fetal loss and a preterm delivery of an infant with congenital tuberculosis. Intervention(s): Endometrial biopsy, acid-fast bacilli culture of urine, and endometrium. Main outcome measure(s): Pregnancy outcomes. Result(s): Fetal loss at 19 weeks and preterm delivery of an infant with congenital tuberculosis before urogenital tuberculosis treatment. Conclusion(s): Patients who are at risk of urogenital tuberculosis should be screened in advance of infertility treatment to potentially prevent adverse pregnancy outcomes.
