Evaluation of the complete profile of male partners in infertile couples with special emphasis on detection of genital tuberculosis


  • Niharika Sethi Department of Obstetrics and Gynecology, Maulana Azad Medical College, New Delhi, India
  • Karandeep Guleria Department of Urology, Post Graduate Institute of Medical Education and Research and Dr Ram Manohar Lohia Hospital, New Delhi, India
  • Devender Verma Department of Obstetrics and Gynecology, Maulana Azad Medical College, New Delhi, India
  • Anjali Tempe Department of Obstetrics and Gynecology, Maulana Azad Medical College, New Delhi, India




Infertility, Sperm, TB, Genital


Background: To evaluate the complete profile of male partners in infertile couples with special emphasis on detection of genital TB.

Methods: The study was conducted in the fertility clinic of department of obstetrics and gynaecology, Maulana Azad Medical College and Associated Lok Nayak and GB Pant Hospitals, New Delhi from August 2015 to December 2016 among 100 infertile couples. Detailed history, general physical and local examination of male partners was done. Routine blood and urine tests, combined with radiology examination of chest and mantoux skin test of male partners were done followed by investigations specific to male factor evaluation. Two semen samples collected after 3-5 days of sexual abstinence were analyzed to assess semen parameters such as volume, total sperm count, total motility and morphology. Ultrasound and colour Doppler of scrotum and hormone analysis was done in all cases of azoopermia, oligoasthenospermia or asthenospermia. Testicular FNAC was done for all cases of azoospermia and oligoasthenospermia to establish cause of male infertility.

Results: 72% couples had primary infertility. 34% males were daily tobacco chewers. 8 males had varicocele and 2 had undescended testes on examination. 60% males had semen analysis in the normal range and 19% had azoospermia. Tobacco chewing, testicular size abnormalities, varicocele, hydrocele were significantly associated with abnormal semen findings. A statistically significant relation was found between elevated S.FSH and semen analysis findings. A statistically significant association was found between penile meatal stenosis, chest X-ray, mantoux test with history of TB in male/female partner.

Conclusions: Primary infertility was more common than secondary infertility in our study group. Addiction was found to be an important factor in infertile men particularly tobacco chewing. Elevated Serum FSH levels were a common finding in males with azoospermia and oligoasthenospermia.


Boivin J, Bunting L, Collins JA, Nygren KG. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Hum Reprod. 2007;22(6): 1506-12.

Jonaidy E, Sadodin SN, Mokhber N, Shakeri MT. Comparing the marital satisfaction in infertile and fertile women referred to the public clinics in Mashhad in 2006-07. Irn J Obs Gynecol Infert. 2009;12(1):7-16.

Barratt CL. Semen analysis is the cornerstone of investigation for male infertility. Practitioner. 2007; 3:8-12.

Parikh FR, Nadkarni SG, Kamat SA, Naik N, Soonawala SB, Parikh RM. Genital TB a major pelvic factor causing infertility in Indian women. Fertil Steril. 1997;67(3):497-500.

Nogales-ortiz F, Tarancon I, Francisco F Nogales JR. The pathology of female genital TB: A 31-year study of 1436 cases. Obstet Gynecol. 1979;53(4):422-8.

Oosthuizen AP, Wessels PH, Hefer JN. TB of the female genital tract in patients attending an infertility clinic. South Afr Med J. 1990;77(11):562-4.

Gladstone BP, Muliyil JP, Jaffar S. Infant morbidity in an Indian slum birth cohort. Arch Dis Child. 2008; 93(6):479-84.

Gupta R, Misra A. Review: Type 2 diabetes in India: regional disparities. Br J Diab Vasc Med. 2007;7(1): 12-6.

Weiske WH, Zhou YH, Dong JJ, Zhi EL, Yao CC, Huang YH, et al. Clinical features and microsurgical reconstruction of congenital unilateral absence of the vas deferens with obstructive azoospermia: a tertiary care center experience. Asian J Androl. 2023;25(1):73-7.

Turek PJ, Cha I, Ljung BM. Systematic fine-needle aspiration of the testis: correlation to biopsy and results of organ “mapping” for mature sperm in azoospermic men. Urology. 1997;49(5):743-8.

Chandley AC, Maclean N, Edmond P, Fletcher J, Watson GS. Cytogenetics and infertility in man: II. Testicular histology and meiosis. ‎Ann Hum Genet. 1976;40(2):165-76.

Butt T, Ahmad RN, Kazmi SY, Afzal RK, Mahmood A. An update on the diagnosis of TB. J Coll Physicians Surg Pak. 2003;13:728-34.

Bhattacharya S, Porter M, Amalraj E, Templeton A, Hamilton M, Lee AJ, et al. The epidemiology of infertility in the North East of Scotland. Hum Reprod. 2009;24(12):3096-107.

Cabrera-León A, Lopez-Villaverde V, Rueda M, Moya-Garrido MN. Calibrated prevalence of infertility in 30-to 49-year-old women according to different approaches: a cross-sectional population-based study. Hum Reprod. 2015;8:226.

Larsen U. Primary and secondary infertility in sub-Saharan Africa. Int J Epidemiol. 2000;29(2):285-91.

Ramlau-Hansen CH, Thulstrup AM, Nohr EA, Bonde JP, Sørensen TI, Olsen J. Subfecundity in overweight and obese couples. Hum Reprod. 2007;22(6):1634-7.

Nguyen RH, Wilcox AJ, Skjærven R, Baird DD. Men's body mass index and infertility. Hum Reprod. 2007; 22(9):2488-93.

Sermondade N, Faure C, Fezeu L, Shayeb AG, Bonde JP, Jensen TK, et al. BMI in relation to sperm count: an updated systematic review and collaborative meta-analysis. Hum Reprod. 2012;12:50.

Chavarro JE, Toth TL, Wright DL, Meeker JD, Hauser R. Body mass index in relation to semen quality, sperm DNA integrity, and serum reproductive hormone levels among men attending an infertility clinic. Fertil Steril. 2010;93(7):2222-31.

Pauli EM, Legro RS, Demers LM, Kunselman AR, Dodson WC, Lee PA. Diminished paternity and gonadal function with increasing obesity in men. Fertil Steril. 2008;90(2):346-51.

Sunanda P, Panda B, Dash C, Ray PK, Padhy RN, Routray P. Prevalence of abnormal spermatozoa in tobacco chewing sub-fertile males. J Hum Reprod Sci. 2014;7(2):136.

Ramlau-Hansen CH, Thulstrup AM, Aggerholm AS, Jensen MS, Toft G, Bonde JP. Is smoking a risk factor for decreased semen quality? A cross-sectional analysis. Hum Reprod. 2007;22(1):188-96.

Dechanet C, Belaisch-Allart J, Hédon B. Prognosis criteria for the management of the infertile couple. J Gynecol Obstet Biol Reprod. 2010;39(8):S9-26.

Zargar AH, Wani AI, Masoodi SR, Laway BA, Salahuddin M. Epidemiologic and etiologic aspects of primary infertility in the Kashmir region of India. Fertil Steril. 1997;68(4):637-43.

Lee HD, Lee HS, Park SH, Jo DG, Choe JH, Lee JS, Seo JT. Causes and classification of male infertility in Korea. Clin Exp Reprod Med. 2012;39(4):172-5.

Shafi H, Esmaeilzadeh S, Delavar MA, Haydari FH, Mahdinejad N, Abedi S. Prevalence of varicocele among primary and secondary infertile men: Association with occupation, smoking and drinking alcohol. North Am J Med Sci. 2014;6(10):532.

Kantartzi PD, Goulis CD, Goulis GD, Papadimas I. Male infertility and varicocele: myths and reality. Hippokratia. 2007;11(3):99-104.

Olesen IA, Andersson AM, Aksglaede L, Skakkebaek NE, Rajpert de ME, Joergensen N, et al. Clinical, genetic, biochemical, and testicular biopsy findings among 1,213 men evaluated for infertility. Fertil Steril. 2017;107(1):74-82.

Sharma N, Sharma V, Singh PR, Sailwal S, Kushwaha RS, Singh RK, et al. Diagnostic value of PCR in genitourinary TB. Indian J Clin Biochem. 2013;28(3): 305-8.

Sinha RK, Mukherjee S, Kamal MR, Karmakar D. TB of the glans penis healing with meatal stenosis. BMJ Case Rep. 2014;5:12-8.

Christensen WI. Genitourinary TB: review of 102 cases. Medicine. 1974;53(5):377-90.

Kumar R. Reproductive tract TB and male infertility. Indian J Urol. 2008;24(3):392.

Regmi SK, Singh UB, Sharma JB, Kumar R. Relevance of semen polymerase chain reaction positive for TB in asymptomatic men undergoing infertility evaluation. J Hum Reprod Sci. 2015;8(3): 165.

Sole-Balcells F, Jimenez-Cruz F, de Cabezon JS, Rosello AS. TB and infertility in men. Euro Urol. 1976;3(3):129-31.

Ajantha GS, Shetty PC, Kulkarni RD, Biradar U. PCR as a diagnostic tool for extra-pulmonary TB. J Clin Diagn Res. 2013;7(6):1012-5.






Original Research Articles