Clinical Features and Outcomes of Tuberculosis after in Vitro Fertilization–Embryo Transfer Compared with Natural Pregnancy: A Retrospective Study

We compared the clinical characteristics and outcomes of active tuberculosis (TB) during pregnancy after in vitro fertilization-embryo transfer (IVF-ET) with those in natural pregnancies. The aim was to assess the impact of the mode of pregnancy on TB and to gain a deeper understanding of the clinical characteristics of TB during pregnancy in women who conceived through IVF-ET. This study retrospectively reviewed medical records to analyze maternal and perinatal outcomes in women with active TB during pregnancy, comparing those who conceived through IVF-ET with those who conceived naturally. Using a 1:2 propensity score matching method, this study included 37 pregnant women with active TB who conceived through IVF-ET and 74 matched pregnant women with active TB who conceived naturally. In the IVF-ET group, all patients developed TB during early to mid-pregnancy, with an average onset at 11 weeks. In contrast, the natural pregnancy group had a later onset, averaging 17 weeks (P = 0.002). The IVF-ET group had higher fever and miliary TB frequency than the natural pregnancy group (94.6% versus 62.2% and 74.3% versus 27.4%, respectively, P <0.05). Although there were no significant differences in maternal intensive care unit admission rates or TB-related mortality between the two groups (24.3% versus 18.9% and 2.7% versus 6.8%, respectively, P >0.05), the IVF-ET group showed higher fetal mortality (94.6% versus 56.8%, respectively, P <0.001). IVF-ET was found to contribute to the exacerbation and spread of TB, underscoring the need for enhanced screening in the future.