DICE—Detection of Infectious Chronic Endometritis test in IVF Treatment

Patient: Dr. Malpani, my IVF doctor, recommended a test called DICE—Detection of Infectious Chronic Endometritis. He said it would check for hidden infections in my uterus that could affect implantation. Should I get it done?

Dr. Malpani: I’m glad you asked before blindly going ahead with it. The truth is, the DICE test is just another money-making gimmick. There’s no solid scientific evidence proving that it improves IVF success rates.

Patient: But my doctor said chronic endometritis could prevent embryo implantation. Isn’t that a valid concern?

Dr. Malpani: While chronic endometritis is a real condition, it’s extremely rare. More importantly, diagnosing it is tricky because many women have some degree of inflammation in their uterus, which is often harmless. DICE claims to detect bacteria that may not even be clinically significant!

Patient: Then why do so many IVF clinics push for this test?

Dr. Malpani: Simple—profit. IVF is already expensive, and unethical doctors exploit vulnerable patients by recommending unnecessary tests. They make it sound scientific by using fancy names like DICE, but in reality, it’s just another way to squeeze more money out of patients.

Patient: My doctor said that if the test is positive, I’ll need antibiotics to clear the infection before transferring my embryos. Won’t that improve my chances?

Dr. Malpani: That’s the trap. Even if the test finds bacteria, it doesn’t mean they are harmful or causing implantation failure. The recommended antibiotics are often broad-spectrum, which may do more harm than good by disturbing your natural vaginal and gut flora.

Patient: So, is there any situation where the DICE test is actually useful?

Dr. Malpani: Not for routine IVF patients. It might be relevant in rare cases where a woman has repeated implantation failures despite transferring good-quality embryos. But even then, the decision should be based on symptoms and medical history, not just a test result.

Patient: I feel so frustrated! IVF is already stressful, and now I learn that some doctors are scamming patients with useless tests. How do I protect myself?

Dr. Malpani: The best defense is knowledge. Always ask your doctor how a test will change your treatment plan. If they can’t give a clear, science-backed explanation, it’s likely unnecessary. Be sceptical of anything that sounds like a “magic solution” for IVF success.

Patient: So, should I just refuse the DICE test?

Dr. Malpani: Absolutely. It’s not going to improve your IVF outcome, and it’s just an extra burden on your time and wallet. Focus on what actually matters—choosing a good IVF lab, ensuring high-quality embryos, and maintaining a positive mindset.

Patient: That makes me feel a lot more empowered. Thank you, Dr. Malpani.

Dr. Malpani: I’m glad to hear that! If you’d like a second opinion, you can fill out the form on our website with your reports, and I’ll provide a free second opinion here. For direct advice, you can also book a video consultation with me for ₹ 3000/-. This could help ensure you’re on the right path and potentially save significant costs in the long run.

The Detection of Infectious Chronic Endometritis (DICE) test is being marketed as a necessary test for IVF patients, but in reality, it’s just another way for unethical doctors to profit from vulnerable couples. Dr. Malpani explains that chronic endometritis is rare and difficult to diagnose accurately. Many IVF clinics push for this test under the guise of improving implantation rates, but there is no solid evidence to support its usefulness.

Worse, a positive DICE result often leads to unnecessary antibiotic treatments, which can disrupt the body's natural bacteria and cause more harm than good. Patients should be wary of doctors who prescribe expensive and unproven tests as part of their IVF journey. The key to IVF success lies in high-quality embryo selection and a good laboratory—not in gimmicky tests like DICE.