Background: Currently, none of the diagnostic procedures for detecting female genital tuberculosis (FGTB) are 100 percent reliable, and the same is true for endoscopic results. There are several studies accessible on hysteroscopic and laparoscopic findings that are suggestive of TB. However, no study to our knowledge summarises the findings of laparoscopic and hysteroscopic examination in subfertile female patients with biopsy, culture, or other laboratory test-proven endometrial tuberculosis. Objective: Evaluation of hysteroscopic and laparoscopic findings in subfertile women suffering from proven endometrial tuberculosis. Materials and methods: 16,784 infertile women had a diagnostic hysterolaparoscopy between February 2014 and June 2021, among which 1084 patients were prescribed anti-tubercular medication based on the results of their findings; however, only 309 individuals had endometrial tuberculosis verified via positive on histopathology examination, AFB demonstration, Culture, and GeneXpert MTB/RIF. We retrospectively observed the diagnostic hysterolaparoscopy findings in those proven cases of subfertile women suffering from FGTB. Results: The major findings on hysteroscopy were periosteal fibrosis (209/309,67.63%), pale endometrium(179/309,57.92%), and micro polyp(138/309,44.66%). Other notable hysteroscopic findings were intrauterine adhesions (88/309,28.47%), endometrial tubercle (78/309,25.24%), endometrial polyp(54/309,14.88%), caseation(42/309,13.59%), focal hyperemia(29/309,9.38%) and diffuse hyperemia(18/309,5.82%). The most common finding on laparoscopy was abdominopelvic adhesions of various grades (297/309,96.11%). The major findings of laparoscopy were tubercle (155/309,50.16%), isthmo ampullary block (118/309,38.18%), tubal diverticula (116/309,37.54%), hydrosalpinx (97/309,31.39%) and TO mass (96/309,31.06%). 5.50% (17/300) had a normal appearance on hysteroscopy, and 1.29% (4/309) had a normal-looking pelvis on laparoscopy. Conclusions: In proven endometrial tuberculosis, significant hysteroscopic findings are periosteal fibrosis, pale endometrium, micro-polyp, and intrauterine adhesions, whereas major laparoscopic findings are various grades of abdominal pelvic adhesions, including perihepatic adhesions, miliary tubercle, isthmo ampullary block, tubal diverticula, caseous material, and hydrosalpinx. Tuberculosis should be considered if these signs are discovered during a diagnostic work-up in infertile people.

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.

BACKGROUND Accessory cavitated uterine malformations, or mass (ACUM) is a Mullerian anomaly which increasingly recognized as a cause of severe dysmenorrhoea and pelvic pain. OBJECTIVE To know what ACUMs are and recognize their clinical presentation, able to diagnose an ACUM using ultrasound or MRI; and counsel patients with ACUMs on the different management options, including conservative, medical, and surgery. CONCLUSION AND WIDER IMPLICATION ACUMs are less rare than previously believed; hence ACUM diagnosis is essential in clinically suspicious cases via ultrasound and MRI, and intra-operative assessment of uterine morphology and laparoscopic surgical excision is the definitive treatment for ACUM.