#127 : Case Series of 26 Pregnant Women with Tuberculosis Recurrence After IVF-ET

Background and Aims: There is limited data on the outcomes of pregnancies complicated by tuberculosis (TB) recurrence following in vitro fertilization-embryo transfer (IVF-ET). This study aims to describe the diagnosis, treatment, and pregnancy prognosis of pregnant women with TB recurrence after IVF-ET.

Methods: A review of 26 patients with TB recurrence after IVF-ET or during the gestation period was conducted.

Results: Pregnancy with TB after IVF-ET was common in women with twin pregnancies and a history of TB, often presenting as fever and vaginal bleeding. Miliary nodules were the primary manifestation on chest imaging, indicating a serious condition. Some patients with extrapulmonary TB exhibited atypical symptoms, leading to missed or misdiagnoses. Among the 26 patients, 22 terminated their pregnancies, and one with tuberculous meningitis underwent a cesarean section 123 days after ET but died 28 days post-operation. Four patients had live births, but three neonates (including two twins) ultimately died after birth due to TB infection or dysplasia.

Conclusion: The prognosis of pregnancies complicated by TB recurrence after IVF-ET is poor. For patients presenting with fever and TB-related symptoms, TB recurrence should be suspected, and multidisciplinary cooperation is advised to confirm the diagnosis and provide timely treatment. If acute miliary TB is diagnosed, pregnancy termination should be considered when necessary. Single embryo transfer is suggested for patients with a history of TB, and frozen embryo transfer may benefit patients at high-risk of TB.