Genital tuberculosis is usually secondary to primary infection (lungs, bones, lymph nodes). It spreads by haematogenous route (not lymphatic route) leading to endosalpingitis. Caseous granulomatous lesions with giant cells on pathological examination are suggestive of TB but is not diagnositic as it can be seen in fungal infection and sarcoidosis. PCR is more sensitive (85–95%) than microscopy and bacteriological culture. This method can detect fewer than 10 organisms in clinical specimens compared to 10,000 necessary for smear positivity. Reproductive outcome even after treatment is poor. Pregnancy rate is about 20%, live birth rate is only 7%. risk of miscarriae and ectopic pregnancy are high.