### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

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Advice please - I am a 35 year old married female. I and my husband have been trying for a baby for last 6 years with no luck. Semen test showed that my husband has a low motility and low morphology. All my blood test came positive. So the diagnosis was male factor teratozoospermia. We tried 3 IUI , then 3 IVF and then 3 frozen cycles, none of them took for us. Then we changed clinic and did a 4th IVF, I became pregnant but in the wrong place. It was an ectopic pregnancy and I had to be operated. Both my tubes were removed. The surgeon told us that the tubes looked infected and that is why they removed both of them. After the surgery we again tried several IVF cycles and none of them succeeded. Around 10 years back, when I was in my college days, I had acute lower abdomen pain with white discharge and I was diagnosed with tuberculosis, and was given anti TB medicine for 9/10 months. After the treatment the white discharge problem disappeared. At that point of time the doctors didnt mention anything about the possibility of infertility in the future. But I am wondering if my tubes were infected due to TB at that time and if I am facing infertility now due to this. Just before the ectopic pregnancy I underwent a hysteroscopy and I was told that the uterus looked normal. A tissue was sent for biopsy and the result came out clean. I am not sure if I there is any point in me continuing to take IVFs. Other than the ectopic pregnancy I have never become pregnant even once. Please let me know if my previous TB treatment could be a cause for this and if there is any hope for me to get pregnant through IVF. I am in great agony after such a long journey in the infertile road.

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Welcome to Chat Doctor, Unfortunately TB of Tubes causes structural damage to the tubes. Inspire of successful treatment for TB, structural damage does not revert to normal. In the majority of cases of TB of Tubes, uterus also gets affected.  In fact, the Doctor should have removed your tubes before your First IVF. Hysteroscopy is a good diagnostic investigation, but again it has its limitations. Biopsy also depends on the quality of sampling, and it can rule out active TB, but the capacity to prepare a bed for fertilized ova to implant is another thing. Male factor also has an important implication on success of fertility. As the age increases, again the chances of Success of IVF reduces. Nevertheless, we should not lose hope. You as a couple should talk to the Doctor, and discuss other options also.