Embryonic Transfer Post-Vaginal Bleeding: Analysis of the Necessity of Tuberculosis Screening

Abstract Objective: To analyze the clinical manifestations and outcomes of 10 cases of post-transplant tuberculosis and to explore the necessity of screening for tuberculosis in patients with vaginal bleeding after in-vitro fertilization-embryo transfer (IVF-ET). Methods: A retrospective analysis was conducted on 10 clinical cases of active tuberculosis during pregnancy following IVF-ET treated at the First Affiliated Hospital of Zhengzhou University from January 2018 to October 2024. The relationship between vaginal bleeding and active tuberculosis was assessed, and the potential value of tuberculosis screening in such patients was discussed. Results: (1) General situation: Among the 10 pregnant patients with confirmed active tuberculosis after IVF-ET, 3 had a history of tuberculosis before pregnancy (3/10), 6 were diagnosed with tuberculosis for the first time during pregnancy (6/10), and 1 was diagnosed with tuberculosis after termination of pregnancy (1/10); all but one were primiparous (9/10). (2) Clinical symptoms: Among the 10 patients, fever of varying degrees was the main symptom in 9 cases (9/10), accompanied by vaginal bleeding in 8 cases (8/10), with the lung being the main affected organ, and the most common types of pulmonary tuberculosis were acute miliary pulmonary tuberculosis and hematogenous disseminated pulmonary tuberculosis. (3) Maternal and fetal outcomes: It took about 2 weeks from the onset of tuberculosis to diagnosis, and only 4 patients (4/10) had viable fetuses; all live birth cases were terminated by cesarean section, with 1 term live birth and 3 newborns born prematurely and transferred to the neonatal department. Conclusion: Pregnancy outcomes in active tuberculosis after embryo transfer are poor. Screening for tuberculosis in patients with vaginal bleeding after IVF-ET is necessary to some extent. Clinically, it is necessary to be vigilant about the possibility of tuberculosis onset in patients after IVF-ET who are preventing miscarriage. Early diagnosis and regular anti-tuberculosis treatment can improve clinical prognosis.