new delhi over 40 women who are not able to give birth are put on tuberculosis drugs on the basis of preliminary diagnostic methods and symptoms which may not be accurate this indiscriminate use of antituberculosis treatment att according to ivf invitro fertilization experts is causing resistance to drugs in infertile women in my experience of 20 years as an ivf expert 600 laparoscopies and 100 hysteroscopies were carried out under my care on urban infertile women attending sgrh though evidence of tb old treated or new is seen in less than 5 of the cases up to 45 of young healthy women are put on att without any confirmatory test said dr abha majumdar head of the department center of ivf and human reproduction sir ganga ram hospital she said that menstrual blood pcr is used by a lot of gynecologist as an easy available source to check for tb bacteria however this does not detect live bacilli but only a segment of the dna strand of the bacilli which could be present by dead or inactive tb bacteria in the absence of diseasecausing bacilli also there are some labs in india that report 4050 of their endometrial samples to be tb pcr positive there is need for stringent regulation of the testing process microbiologist dr chand wattal said genital tuberculosis usually occurs secondary to primary infection in the lungs direct test for definitive confirmation of active genital tuberculosis is needed for eg through histopathology or by direct visualization of tb bacteria laparoscopy and hysteroscopy are good tests where visualization of caseating tuberculomas is almost confirmatory to diagnose genital tuberculosis clinically he said experts say that tb causes infertility only if it damages or blocks the tubes and not merely by presence of sleeping bacteria in the body and therefore not all infertile women need to be put on att