Effects of antituberculosis treatment on pregnancy outcomes in infertile women with genital tuberculosis: a systematic review

OBJECTIVES: To evaluate the efficacy of antituberculosis therapy on pregnancy outcomes in infertile women with genital tuberculosis. DESIGN: Systematic review. DATA SOURCES: We searched in PubMed/MEDLINE, CENTRAL and EMBASE up to 15 January 2023. Additionally, we manually search the reference lists...

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Autores principales: Flores-Lovon, Kevin, Soriano‐Moreno, David R., Medina Ramirez, Sebastian Andre, Fernandez‐Guzman, Daniel, Caira‐Chuquineyra, Brenda, Fernandez-Morales, Jared, Tuco, Kimberly G., Turpo-Prieto, John, Alave Rosas, Jorge Luis, Goicochea-Lugo, Sergio
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Publicado: 2023
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author Flores-Lovon, Kevin
Soriano‐Moreno, David R.
Medina Ramirez, Sebastian Andre
Fernandez‐Guzman, Daniel
Caira‐Chuquineyra, Brenda
Fernandez-Morales, Jared
Tuco, Kimberly G.
Turpo-Prieto, John
Alave Rosas, Jorge Luis
Goicochea-Lugo, Sergio
author_browse Alave Rosas, Jorge Luis
Caira‐Chuquineyra, Brenda
Fernandez-Morales, Jared
Fernandez‐Guzman, Daniel
Flores-Lovon, Kevin
Goicochea-Lugo, Sergio
Medina Ramirez, Sebastian Andre
Soriano‐Moreno, David R.
Tuco, Kimberly G.
Turpo-Prieto, John
author_facet Flores-Lovon, Kevin
Soriano‐Moreno, David R.
Medina Ramirez, Sebastian Andre
Fernandez‐Guzman, Daniel
Caira‐Chuquineyra, Brenda
Fernandez-Morales, Jared
Tuco, Kimberly G.
Turpo-Prieto, John
Alave Rosas, Jorge Luis
Goicochea-Lugo, Sergio
author_sort Flores-Lovon, Kevin
collection Producción científica
description OBJECTIVES: To evaluate the efficacy of antituberculosis therapy on pregnancy outcomes in infertile women with genital tuberculosis. DESIGN: Systematic review. DATA SOURCES: We searched in PubMed/MEDLINE, CENTRAL and EMBASE up to 15 January 2023. Additionally, we manually search the reference lists of included studies. ELIGIBILITY CRITERIA: We included randomised controlled trials (RCT), non-RCTs (non-RCT) and cohort studies that evaluated the effects of antituberculosis treatment on pregnancy outcomes in infertile women with genital tuberculosis compared with not receiving antituberculosis treatment or receiving the treatment for a shorter period. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers extracted data. We used Cochrane Risk of Bias 1.0 and Risk Of Bias In Non-randomised Studies tools for risk of bias assessment and meta-analysis was not performed. We used Grading of Recommendations, Assessment, Development and Evaluations approach to assess the certainty of the evidence. RESULTS: Two RCTs and one non-RCT were included. The antituberculosis regimens were based on isoniazid, rifampicin, pyrazinamide and ethambutol for 6-12 months. In women without structural damage, very low certainty of evidence from one RCT showed that the antituberculosis treatment may have little to no effect on pregnancy, full-term pregnancy, abortion or intrauterine death and ectopic pregnancy, but the evidence is very uncertain. In women with structural damage, very low certainty of evidence from one non-RCT showed that the antituberculosis treatment may reduce the pregnancy rate (297 fewer per 1000, 95% CI -416 to -101), but the evidence is very uncertain. In addition, very low certainty of evidence from one RCT compared a 9-month vs 6-month antituberculosis treatment regimen showed similar effects between the schemes, but the evidence is very uncertain. Two RCTs reported that no adverse events of antituberculosis treatment were noted or were similar in both groups. CONCLUSION: The effect of antituberculosis treatment on pregnancy outcomes in infertile women with genital tuberculosis is very uncertain. PROSPERO REGISTRATION NUMBER: CRD42022273145.
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spelling oai:cris.upeu.edu.pe:20.500.15037/1592026-11-02T12:57:04ZEffects of antituberculosis treatment on pregnancy outcomes in infertile women with genital tuberculosis: a systematic reviewFlores-Lovon, KevinSoriano‐Moreno, David R.Medina Ramirez, Sebastian AndreFernandez‐Guzman, DanielCaira‐Chuquineyra, BrendaFernandez-Morales, JaredTuco, Kimberly G.Turpo-Prieto, JohnAlave Rosas, Jorge LuisGoicochea-Lugo, SergioTuberculosisMale infertilityReproductive MedicineOBJECTIVES: To evaluate the efficacy of antituberculosis therapy on pregnancy outcomes in infertile women with genital tuberculosis. DESIGN: Systematic review. DATA SOURCES: We searched in PubMed/MEDLINE, CENTRAL and EMBASE up to 15 January 2023. Additionally, we manually search the reference lists of included studies. ELIGIBILITY CRITERIA: We included randomised controlled trials (RCT), non-RCTs (non-RCT) and cohort studies that evaluated the effects of antituberculosis treatment on pregnancy outcomes in infertile women with genital tuberculosis compared with not receiving antituberculosis treatment or receiving the treatment for a shorter period. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers extracted data. We used Cochrane Risk of Bias 1.0 and Risk Of Bias In Non-randomised Studies tools for risk of bias assessment and meta-analysis was not performed. We used Grading of Recommendations, Assessment, Development and Evaluations approach to assess the certainty of the evidence. RESULTS: Two RCTs and one non-RCT were included. The antituberculosis regimens were based on isoniazid, rifampicin, pyrazinamide and ethambutol for 6-12 months. In women without structural damage, very low certainty of evidence from one RCT showed that the antituberculosis treatment may have little to no effect on pregnancy, full-term pregnancy, abortion or intrauterine death and ectopic pregnancy, but the evidence is very uncertain. In women with structural damage, very low certainty of evidence from one non-RCT showed that the antituberculosis treatment may reduce the pregnancy rate (297 fewer per 1000, 95% CI -416 to -101), but the evidence is very uncertain. In addition, very low certainty of evidence from one RCT compared a 9-month vs 6-month antituberculosis treatment regimen showed similar effects between the schemes, but the evidence is very uncertain. Two RCTs reported that no adverse events of antituberculosis treatment were noted or were similar in both groups. CONCLUSION: The effect of antituberculosis treatment on pregnancy outcomes in infertile women with genital tuberculosis is very uncertain. PROSPERO REGISTRATION NUMBER: CRD42022273145.Reviewhttps://pubmed.ncbi.nlm.nih.gov/37758670https://bmjopen.bmj.com/content/bmjopen/13/9/e070456.full.pdfhttps://doi.org/10.1136/bmjopen-2022-070456PMC1053786810.1136/bmjopen-2022-070456https://hdl.handle.net/20.500.15037/15937758670W4387078615enBMJ Open2044-60552023-09-012026-06-13T07:48:36Z2026-06-13T07:48:36Z
spellingShingle Tuberculosis
Male infertility
Reproductive Medicine
Flores-Lovon, Kevin
Soriano‐Moreno, David R.
Medina Ramirez, Sebastian Andre
Fernandez‐Guzman, Daniel
Caira‐Chuquineyra, Brenda
Fernandez-Morales, Jared
Tuco, Kimberly G.
Turpo-Prieto, John
Alave Rosas, Jorge Luis
Goicochea-Lugo, Sergio
Effects of antituberculosis treatment on pregnancy outcomes in infertile women with genital tuberculosis: a systematic review
title Effects of antituberculosis treatment on pregnancy outcomes in infertile women with genital tuberculosis: a systematic review
title_full Effects of antituberculosis treatment on pregnancy outcomes in infertile women with genital tuberculosis: a systematic review
title_fullStr Effects of antituberculosis treatment on pregnancy outcomes in infertile women with genital tuberculosis: a systematic review
title_full_unstemmed Effects of antituberculosis treatment on pregnancy outcomes in infertile women with genital tuberculosis: a systematic review
title_short Effects of antituberculosis treatment on pregnancy outcomes in infertile women with genital tuberculosis: a systematic review
title_sort effects of antituberculosis treatment on pregnancy outcomes in infertile women with genital tuberculosis a systematic review
topic Tuberculosis
Male infertility
Reproductive Medicine
topic_facet Tuberculosis
Male infertility
Reproductive Medicine
url https://pubmed.ncbi.nlm.nih.gov/37758670
https://bmjopen.bmj.com/content/bmjopen/13/9/e070456.full.pdf
https://doi.org/10.1136/bmjopen-2022-070456
https://hdl.handle.net/20.500.15037/159
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