A patient just send me this email

I have had a sperm test done and my Sperm DNA Fragmentation ( DFI) index count is 40 %. My doctor says my wife will require a sperm donor. 

This is a classic example of how over-testing leads to poor medical care and harms patients.

Doctors don't understand the limitations of the newer medical tests, and are quite happy to order the "latest and most expensive " tests when treating their patients - especially when they have no idea what's going on ! They cloak their ignorance with the garb of sophisticated scientific test results - and the poor patient gets misled !

The reality is that there is no correlation between  sperm DFI and male fertility. Lots of fertile men will have  a high sperm DFI , but they have enough sense not to go to a doctor to get it tested ! There's too much overlap in the sperm DFI results in fertile men and infertile men to make the test meaningful or useful.

However, doctors don't understand that these tests are riddled with the problem of false positives, and are very happy to "treat" the abnormal test result ( because they forget that they should be treating the patients, and not the lab report !)

So what role does sperm DFI testing have to play ? It should be used very selectively, only for couples who plan to do IVF. Studies should that if a couple needs IVF, if the man has a high sperm DFI, they should opt for ICSI rather than IVF , because the fertilisation rate with IVF is lower as compared to ICSI in these men, that's all !

The only way to protect yourself from clueless doctors is by investing in Information Therapy !

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