title: Relevance of semen polymerase chain reaction positive for tuberculosis in asymptomatic men undergoing infertility evaluation.
abstract: OBJECTIVE
  Male partners of infertile women with genital tuberculosis (TB) are often screened for genital TB. We aimed to evaluate the clinical significance of a positive screening semen polymerase chain reaction (PCR) for Mycobacterium tuberculosis test (TB-PCR) in asymptomatic men undergoing infertility evaluation and determine the need for a detailed investigation and treatment for TB.
  
  
  METHODS
  Between March 2012 and January 2013, male partners of 15 infertile women with a diagnosis of genitourinary TB (GUTB) as the cause of infertility, tested positive either on semen PCR for TB (13 cases), or Mycobacterium Growth Indicator Tube-960 test (2 cases). These asymptomatic men underwent infertility evaluation along with evaluation for GUTB. Diagnosis of GUTB was based on standard clinical criteria, which included a high index of suspicion along with clinical, laboratory, and/or radiological evidence of GUTB. Men who had no clinical evidence of GUTB were followed up with clinical evaluation, semen analysis, and repeat semen PCR for TB after 6 months.
  
  
  RESULTS
  Fourteen subjects consented for inclusion in the study. One had a history of pulmonary TB 20 years earlier. Another patient was found to have mediastinal lymphadenopathy (tubercular). All except one had a normal semen analysis. None of the patients met the standard clinical criteria for GUTB diagnosis. 8 patients followed up at 6 months with repeat semen analysis, which was similar to the baseline values and no clinical evidence of TB.
  
  
  CONCLUSIONS
  Asymptomatic men with positive screening semen PCR for TB do not have clinical evidence of TB. Male partners of women with infertility and GUTB should not be screened if they have no symptoms.
authors.affiliation: Department of Urology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Subodh Kumar
authors.initials: SK
authors.lastname: Regmi
authors.affiliation: Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Urvashi B
authors.initials: UB
authors.lastname: Singh
authors.affiliation: Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Jai Bhagwan
authors.initials: JB
authors.lastname: Sharma
authors.affiliation: Department of Urology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Kumar
keywords: Infertility; polymerase chain reaction; screening; semen; tuberculosis