Reproductive tract tuberculosis and male infertility

Infertility is an uncommon manifestation of genitourinary tract tuberculosis. Anatomic obstruction by granulomas or distortion of the normal anatomy by fibrosis surrounding the reproductive tract structures is the commonest cause of infertility. The diagnosis is usually based on a suggestive history along with evidence of granulomatous infection on a tissue sample. The management depends on the site of obstruction and surgery is usually helpful only in cases with discrete ejaculatory duct obstruction. However, most other patients are candidates for in-vitro fertilization and have a prognosis similar to that in men with other causes of obstructive azoospermia.