Introduction

In India, Africa, and other underdeveloped nations, female genital tuberculosis (FGTB) is a prevalent cause of infertility; however, accurate diagnosis is difficult to come by because of paucibacillary illness. Fifty percent of extrapulmonary tuberculosis(EPTB) cases in India were found in HIV-positive people, whereas the remaining 15 to 20% were in immune-competent patients. (1,2). Among these, 9% are FGTB in women’s reproductive age group, adversely affecting their reproductive health. (1,2)Acid-fast bacilli on endometrial or peritoneal biopsy, epithelioid granuloma on biopsy, or a positive MTB gene Xpert on biopsy are all conventional techniques of diagnosis. There is a minimal chance of success with these, however. Due to the high rate of false positive results, a positive polymerase chain reaction (PCR) cannot be relied upon as diagnostic evidence on its own. When conventional TB tests are negative for a patient, diagnostic laparoscopy and hysteroscopy may often reveal the presence of TB lesions. FGTB significantly affects women’s chance of conception by distorting anatomically and pathophysiologically reproductive organs. (3–5) The presence of characteristic caseous granuloma, with or without Langerhans giant cells, is indicative of genital tuberculosis when exhibited on histology. (6) The crucial histologic finding to diagnose endometrial tuberculosis is the presence of epithelioid cell granulomas in different stages and multinucleated giant cells of both Langhans and foreign body type and lymphoid aggregate. (7,8) The ability to see acid-fast bacilli(AFB) and the discovery of caseation are two other findings. Those who identify these characteristics on endometrial biopsy are thus included in the study population. In addition, C cartridge-based nucleic acid amplification tests (CBNAAT/ Xpert MTB/RIF assay) and liquid culture by mycobacterial growth indicator tube (MGIT) with phenotypic drug sensitivity testing (DST) are  WHO-approved rapid diagnostic tests. (6,9)
Several observations made during laparoscopy and hysteroscopy have been mentioned in the published research relevant to FGTB.(6,10–12). In addition, treatment with anti-tubercular medication is started once that has been determined to be necessary. However, there is no such paper that discusses the results of laparoscopic and hysteroscopic examinations in female patients who have been diagnosed with subfertility and endometrial tuberculosis.