Are IVF Clinics Making You Waste Money on Useless Tests?
Patient: Dr Malpani, I recently saw another IVF doctor who suggested a long list of tests—PGT-A, ERA, sperm DNA fragmentation, and chromosome studies. I’m feeling overwhelmed. Are all these really necessary?
Dr. Malpani: I'm glad you're asking. Many of these so-called "advanced" tests are actually unnecessary in most cases. Unfortunately, some IVF clinics exploit patient anxiety to recommend expensive tests that don’t actually improve outcomes.
Patient: So let’s start with men. What’s the one essential test for male fertility?
Dr. Malpani: A semen analysis. That’s it. It helps us understand the sperm count and motility. But even then, it can’t answer the real question patients want: “Can I get my wife pregnant?” Because fertility is not just about numbers—it’s about function. And many men with poor counts still father children naturally.
Patient: But what about sperm DNA fragmentation and chromosome studies? Aren’t those helpful?
Dr. Malpani: They sound scientific and fancy, but the reality is they rarely change treatment decisions. Many of these tests have poor predictive value. If a man has sperm in his ejaculate, we can use ICSI. That’s usually all we need to know.
Patient: That’s surprising. So why do doctors still order them?
Dr. Malpani: There are two reasons: fear and financial incentives. Clinics want to appear thorough, and these tests pad their bills. But most aren't evidence-based. We need to go back to science, not superstition.
Patient: Okay. Let’s talk about women. Are there similar unnecessary tests for them?
Dr. Malpani: Yes, and even more. ERA (Endometrial Receptivity Assay), immune testing, and PGT-A embryo biopsy—all very expensive, often marketed as "add-ons". These are pushed especially after a failed IVF cycle, when the patient is emotionally vulnerable.
Patient: But isn’t it logical to do more tests if a cycle fails?
Dr. Malpani: Logically, yes. Emotionally, absolutely. But medically? Not always. IVF success depends on embryo quality and uterine receptivity—but most of these tests don’t give actionable insights. They give the illusion of control, not real clarity.
Patient: So if the embryo didn’t implant, what should we do instead of these tests?
Dr. Malpani: First, review the cycle scientifically. Was the embryo a blastocyst? Was the transfer smooth? What’s the woman’s age and ovarian reserve? Many times, it’s just a matter of trying again with a frozen embryo transfer—without additional testing.
Patient: How much do these add-on tests cost?
Dr. Malpani: ERA and embryo biopsy with PGT-A each cost ₹30,000–₹40,000 or more. And that’s on top of the base IVF cycle, which may cost ₹2–3 lakhs, excluding meds. Patients often end up spending lakhs more on tests that don’t improve outcomes.
Patient: That’s shocking. Why don’t more patients question this?
Dr. Malpani: Because they trust their doctor, which is good. But blind trust is risky. I tell patients to ask just one question: "How will this test change my treatment?" If it won’t change anything, skip it. Don’t let doctors use you as a guinea pig.
Patient: So what’s your advice to IVF patients when a test is recommended?
Dr. Malpani: Ask tough questions. Take notes. Get a second opinion if needed. IVF is expensive and emotionally draining. You deserve to know whether a test is necessary—or just a revenue generator for the clinic.
Stay informed. Don’t let confusion—or clever marketing—cloud your decisions. You’re in charge of your IVF journey.