**Core Concept**
Female genital tuberculosis (FGTB) is a rare but serious complication of extrapulmonary tuberculosis, primarily affecting the fallopian tubes, uterus, and ovaries. FGTB is often a result of hematogenous spread from an initial focus of infection, usually in the lungs.

**Why the Correct Answer is Right**
The correct answer is related to the pathophysiology of FGTB. FGTB typically affects the fallopian tubes, causing chronic inflammation, scarring, and eventual destruction of the tubal architecture. This can lead to infertility, ectopic pregnancy, and pelvic pain. The involvement of the fallopian tubes is a hallmark of FGTB, and it is often the primary site of infection.

**Why Each Wrong Option is Incorrect**
**Option A:** This option might suggest that FGTB is common, which is not true. FGTB is a rare complication of tuberculosis, accounting for only 1-3% of all extrapulmonary tuberculosis cases.
**Option B:** This option might imply that FGTB is primarily a sexually transmitted disease, which is incorrect. FGTB is a hematogenous spread from an initial focus of infection, usually in the lungs.
**Option C:** This option might suggest that FGTB is limited to the vagina and cervix, which is not true. FGTB can affect the fallopian tubes, uterus, and ovaries, in addition to the vagina and cervix.

**Clinical Pearl / High-Yield Fact**
FGTB is often referred to as a "silent disease" because it may not present with symptoms, making it challenging to diagnose. A high index of suspicion is required, especially in patients with a history of tuberculosis or unexplained infertility.

**Correct Answer: D.**