Ms. Wang, 30, who had not been pregnant for four years after her marriage, was desperate for a baby and switched to IVF treatment after unsuccessful IUI, but with great expectation she was hit again at the first quality embryo transfer. After a negative pregnancy test, the doctor recommended a test for tuberculosis infection, and Ms. Wang was confused: “There is no tuberculosis in me or in anyone I have contacted, and now I am infertile, why should I be tested for tuberculosis?” After the doctor’s detailed explanation, she cooperated and completed the test, and the result was positive. After three months of anti-tuberculosis treatment, a second embryo transfer was arranged after systematic examination and treatment, and she finally fulfilled her wish to be a beautiful mother. Let’s learn more about another landmine of infertility: tuberculosis infection. Genital tuberculosis, also known as pelvic tuberculosis, is an inflammatory disease of the female genitalia caused by Mycobacterium tuberculosis, which is a local manifestation of systemic tuberculosis. It is mostly seen in women in their reproductive years (20-40 years old), and the incidence of this disease accounts for about 10% of women with infertility, and most of them come from secondary tuberculosis infection, which spreads to the uterus and fallopian tubes through the bloodstream. Especially during the reproductive period, when the genital blood supply is abundant, Mycobacterium tuberculosis is easily transmitted to the reproductive organs via bloodstream. Tuberculosis in the pelvis is most common in the fallopian tubes, which account for about 85% to 95% of female genital tuberculosis, mostly bilateral. Tuberculosis bacilli can thicken and harden the fallopian tubes, and can destroy the cilia on their mucosal surface, causing adhesions in the walls and occlusion of the lumen. Tubercle bacilli can also invade the endometrium and cause endometrial tuberculosis, which often spreads from tubal tuberculosis, and about 50% of patients with tubal tuberculosis also have endometrial tuberculosis. The endometrium of the uterus can be damaged to varying degrees by Mycobacterium tuberculosis and even involve the myometrium, resulting in the formation of scar tissue, narrowing and deformation of the official cavity, or even adhesion of the official cavity, which can lead to infertility, implantation failure or miscarriage by preventing the fertilization of the egg. Therefore, for patients with infertility, especially those with combined hydrocele, unexplained decrease in menstrual flow, and repeated implantation failure, we recommend “mine-clearing” work related to tuberculosis, as well as early detection and treatment. The “mine-clearing” work includes chest X-ray, blood nodule test, tuberculin test and other systematic examinations. For those with positive initial screening, further laparoscopy, hysteroscopy and tissue biopsy will be performed to determine the status of TB infection. The main “mine-digging weapon” is the use of anti-tuberculosis drugs. However, in order to achieve the desired efficacy, it is necessary to implement the five principles of rationalized treatment, namely early, combined, appropriate, adequate and regular use of sensitive drugs. Early tuberculosis lesions are at the stage of bacterial multiplication, the earlier the lesions are fresh, the better the blood supply, the easier the drugs penetrate, and the more aggressive treatment can prevent the formation of intractable chronic caseating lesions. Generally regular systemic treatment is reviewed after 3-6 months. In cases of stubbornness, ineffective drug treatment, or combined with the need for surgical investigation, laparoscopic exploration and biopsy are performed when necessary. For those who cause uterine adhesions, hysteroscopic adhesion release is needed to restore the normal shape of the uterine cavity and create conditions for embryo implantation. Careful and diligent mine-clearing work, without letting go of any dead ends, can create conditions to ensure victory in the war of infertility. Good pregnancy, let’s work together.