en MIS MIS Case Report Case Report Background: Female genital tuberculosis is an important cause of secondary amenorrhea<br> and infertility in developing countries where tuberculosis is endemic.<br> Objectives: We present three cases in which endometrial tuberculosis was a cause of secondary<br> amenorrhea and infertility.<br> Patients and Methods: In a retrospective study from January 2007 to June 2010, we conducted<br> 1010 laparoscopies for infertile patients. Among these patients, three had secondary<br> amenorrhea and infertility; therefore, they underwent hysteroscopy and endometrial<br> biopsy.<br> Results: The laparoscopic findings showed normal uterus and ovaries in all three patients;<br> although the fallopian tubes were patent in one patient, they blocked in the other two. Hysteroscopy<br> findings revealed that the endometrial layer was atrophied in all three patients,<br> and biopsy results revealed the presence of acid-fast bacilli using Zeihl-Neelsen stain.<br> Conclusions: Patients with genital tuberculosis may have no documented history of tuberculosis<br> or may have evidence of tuberculosis lesions elsewhere in the body. Histopathological<br> evidence from biopsies of premenstrual endometrial tissue or demonstration of tubercle<br> bacilli in cultures of menstrual blood or endometrial curetting is necessary to reach<br> a conclusive diagnosis of the disease. When our patients were treated with antituberculosis<br> treatment for 1 year they regained their menstruation but did not achieve pregnancy.<br> Of note, if a patient conceives after genital tuberculosis infection, there is an increased<br> chance of an ectopic pregnancy as a consequence of chronic salpingitis and tubal damage.<br> Gynecologists in developing countries must consider genital tuberculosis as an important<br> cause of tubal blockage and secondary amenorrhea that leads to infertility Tuberculosis Amenorrhea Hysteroscopy 0 0 http://annbsurg.iums.ac.ir/browse.php?a_code=A-10-31-233&slc_lang=en&sid=1 Wisal Omer M. Nabag 1003194753284600594 1003194753284600594 Yes 1 Department of Obstetrics and Gynecology, Alziem ALazhari University, Khartoum, Sudan Hassan Abdullahi Nur 1003194753284600595 1003194753284600595 No 2 Infectious Disease and Clinical Microbiology Department, Alziem ALazhari University, Khartoum, Sudan Dya Eldeen M. Sayed 1003194753284600596 1003194753284600596 No 3 Community Medicine, Alziem ALazhari University, Khartoum, Sudan Mohamed A. El Sheikh 1003194753284600597 1003194753284600597 No 4 Department of Obstetrics and Gynecology, University of Khartoum, Khartoum, Sudan