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Unraveling the Truth: The Unnecessary Tests and Misinformation Surrounding Male Infertility in IVF Clinics

I am dismayed by how badly men are treated in IVF clinics.

The only test most husbands actually require is a simple test - a semen analysis. If the semen analysis is normal, they really don’t require any further testing at all! In spite of this, gynecologists will routinely subject these men to all kinds of tests for no rhyme or reason. This is often a "Male Infertility Testing Panel", which includes expensive and esoteric tests such as sperm DNA fragmentation, which are of no clinical importance. The justification is that a simple semen analysis test will not be able to identify all abnormalities, which is why more sophisticated tests are needed to pinpoint problems that would otherwise have been missed. Of course, the more tests you do, the higher the chances of finding a problem, so patients are often sent on a chase for unimportant red herrings!

Also, many of these IVF clinics will routinely refer all men to a friendly urologist or andrologist for a second opinion and a clinical examination. He will then routinely do a Doppler ultrasound to check for varicoceles, even though this is of no clinical importance because this is part of the "standard workup"!

What’s even worse is that many IVF labs will deliberately misreport the semen sample as being abnormal, by claiming there are a high number of abnormal sperm forms - what is known as teratozoospermia ( even though they never actually do the test for checking sperm morphology ).

This abnormal report then gives them the excuse they need to subject these hapless men to an entire battery of additional tests, such as chromosomal studies, or tests to check for microdeletion of the Y chromosome, even though these are of no importance. This is partly because gynecologists don't understand that these tests are not useful or relevant. They attend a conference, and when some specialist tells them what tests need to be done, they dutifully copy down all the tests recommended, and order these as a panel to every unfortunate man who walks into their clinic!

What can you do to protect yourself? My advice is very simple! If your husband has a normal semen analysis, there is no need to do any further testing for him! If any doctor tells you to do this, this is a red flag, and you should walk out as quickly as possible

Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.