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\begin{document}

\title{Female genital Tuberculosis in infertile women: a practical paradigm for
management based on reproductive outcome on retrospective analysis of
various subfertility therapies following anti-tubercular therapy}



\author[1]{Rana Mondal}%
\author[1]{Neha Jaiswal}%
\author[1]{Priya Bhave}%
\affil[1]{Bansal Hospital}%


\vspace{-1em}



  
  \date{June 08, 2024}


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\selectlanguage{english}
\begin{abstract}
Objectives To determine fertility outcomes after diagnosing genital
tuberculosis followed by anti-tubercular therapy (ATT) and response to
different subfertility treatment modalities. Hysteroscopy and
laparoscopy data were also analysed to determine whether or not starting
ATT early on in the course of tuberculosis treatment was more effective.
Study design Among the infertile women, presented in department
Reproductive Medicine in Bansal Hospital, Bhopal from Feb 2014 to June
2022, who underwent diagnostic hysteroscopy and laparoscopy, 1083 women
having positive finding(s) suggestive of tuberculosis were received
anti-tubercular therapy for at least six months. Retrospectively, we
analysed the pregnancy outcome of these women after receiving
anti-tubercular therapy followed by different subfertility treatments.
Results In vitro fertilization (IVF) was a primary modality of
treatment. 551(55.88\%) women undergoing IVF with their oocytes resulted
in 348(63.15\%) clinical pregnancies, 264(47.91\%) ongoing pregnancies,
84(15.24\%) first-trimester miscarriages, and live birth in 246(44.64\%)
women. Clinical pregnancy rate, ongoing pregnancy rate, and live birth
rate all show a statistically significant (P = 0.039) improvement when
illness is diagnosed early through hystero-laparoscopy and treated with
ATT, followed by fertility therapy. Conclusions Diagnostic hysteroscopy
and laparoscopy may be performed to examine high-risk infertile
individuals by analysing the reproductive system, including tubal
factor. This helps choose a treatment strategy and forecast its success.
This study shows that if ATT initiated at early stage as suggested by
endoscopy findings IVF reproductive outcomes equivalent to the
background population. Late-stage ATT results are often quite dismal,
despite the fact that IVF and other adjuvant therapy may improve
fertility.%
\end{abstract}%



\sloppy


\textbf{Hosted file}

\verb`(MAIN) Reproductive outcome after different subfertility treatments in infertile women with female genital tuberculosis after receiving anti (AutoRecovered).docx`  available at \url{https://authorea.com/users/502862/articles/648135-female-genital-tuberculosis-in-infertile-women-a-practical-paradigm-for-management-based-on-reproductive-outcome-on-retrospective-analysis-of-various-subfertility-therapies-following-anti-tubercular-therapy}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Fig-1-Major-hysteroscopic-findings-in-female-genital-tuberculosis/Fig-1-Major-hysteroscopic-findings-in-female-genital-tuberculosis}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Fig-2-Major-laparoscopic-findings-in-women-with-female-genital-tuberculosis/Fig-2-Major-laparoscopic-findings-in-women-with-female-genital-tuberculosis}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Fig-3-Various-tubal-abnormality-can-be-found-in-women-with-female-genital-tuberculosis/Fig-3-Various-tubal-abnormality-can-be-found-in-women-with-female-genital-tuberculosis}

\end{center}
\end{figure}

\textbf{Hosted file}

\verb`Fig 4 A practical paradigm approach in infertile women with female genital tuberculosis.docx`  available at \url{https://authorea.com/users/502862/articles/648135-female-genital-tuberculosis-in-infertile-women-a-practical-paradigm-for-management-based-on-reproductive-outcome-on-retrospective-analysis-of-various-subfertility-therapies-following-anti-tubercular-therapy}

\textbf{Hosted file}

\verb`Table 1 consort for reproductive outcome after ATT.docx`  available at \url{https://authorea.com/users/502862/articles/648135-female-genital-tuberculosis-in-infertile-women-a-practical-paradigm-for-management-based-on-reproductive-outcome-on-retrospective-analysis-of-various-subfertility-therapies-following-anti-tubercular-therapy}

\textbf{Hosted file}

\verb`Table 2 Hysteroscopic and laparoscopic findings seen in study population.docx`  available at \url{https://authorea.com/users/502862/articles/648135-female-genital-tuberculosis-in-infertile-women-a-practical-paradigm-for-management-based-on-reproductive-outcome-on-retrospective-analysis-of-various-subfertility-therapies-following-anti-tubercular-therapy}

\textbf{Hosted file}

\verb`Table 3 comparison between different subfertility treatment and reproductive outcome.docx`  available at \url{https://authorea.com/users/502862/articles/648135-female-genital-tuberculosis-in-infertile-women-a-practical-paradigm-for-management-based-on-reproductive-outcome-on-retrospective-analysis-of-various-subfertility-therapies-following-anti-tubercular-therapy}

\textbf{Hosted file}

\verb`Table 4 Hysteroscopic and laparoscopic findings suggestive of different stages of tuberculosis.docx`  available at \url{https://authorea.com/users/502862/articles/648135-female-genital-tuberculosis-in-infertile-women-a-practical-paradigm-for-management-based-on-reproductive-outcome-on-retrospective-analysis-of-various-subfertility-therapies-following-anti-tubercular-therapy}

\selectlanguage{english}
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\end{document}

