Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 6 3 2012 09 14 139 141 Megha Singhal IVF and Reproductive Biology Centre, Department of Obstetrics & Gynaecology, Maulana Azad Medical College, New Delhi, India AND Division of Biotechnology/Molecular Diagnostics & Microbiology, National Centre for Disease Control, Delhi, India Renu Tanwar IVF and Reproductive Biology Centre, Department of Obstetrics & Gynaecology, Maulana Azad Medical College, New Delhi, India Ashok Kumar IVF and Reproductive Biology Centre, Department of Obstetrics & Gynaecology, Maulana Azad Medical College, New Delhi, India Sudha Prasad IVF and Reproductive Biology Centre, Department of Obstetrics & Gynaecology, Maulana Azad Medical College, New Delhi, India 2015 10 04 A 25-year-old female presented to the infertility OPD with complaints of secondary infertility and pain lower abdomen with watery discharge for the past five days. She had history of undergoing hysterosalpingography in a private hospital ten days back. The interventions included drainage of pyometra, endometrial biopsy for routine and AFB smear/ culture,  confirmation of diagnosis by mRNA-based RT-PCR for detection of M. tuberculosis-specific 85B antigen gene, anti-tubercular therapy. Pyometra and tubo-ovarian masses disappeared and patient resumed her normal period post-treatment. Genital tuberculosis was confirmed by mRNA-based RT-PCR and the disease resolved after anti-tubercular therapy. We conclude that a combination of high degree of clinical suspicion and ‘high-precision' gene detection methods (e.g. mRNA) in culture-negative cases may be useful in diagnosis of genital tuberculosis, particularly in infertile patients presenting with pyometra post-hysterosalpingography. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/157 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/157/157