Why Sperm DNA Fragmentation Testing is Often Unnecessary for Infertility Treatment

Patient: Dr. Malpani, I’ve been reading about sperm DNA fragmentation testing. Some clinics are recommending it for infertile men. Do I really need this test?

Dr. Malpani: It’s a common question, and the simple answer is no. Infertile men typically require only one test—a semen analysis. It’s a straightforward test that provides us with all the essential information.

Patient: But I’ve heard that even men who seem healthy can have high sperm DNA fragmentation. Isn't this test important?

Dr. Malpani: That’s the impression some clinics give, but it’s misleading. High sperm DNA fragmentation is not uncommon, even among men who have fathered children naturally. Many of these tests cause unnecessary anxiety. After all, sperm DNA is already present in the testis, so testing for fragmentation often adds no meaningful information.

Patient: Then why do clinics push this test?

Dr. Malpani: Unfortunately, the more complex the test, the more it costs, and the more appealing it appears to patients. The latest trend in IVF clinics is this so-called Sperm DNA Fragmentation Index. It sounds impressive, and it’s marketed as a crucial test. But the reality is, it's mostly a money-making racket.

Patient: So, what happens if someone has a high sperm DNA fragmentation index?

Dr. Malpani: Some doctors might suggest more invasive procedures like testicular sperm aspiration, claiming they can avoid using sperm from the semen. They propose taking sperm directly from the testis. However, this advice is flawed. The DNA fragmentation will be present in the testicular sperm as well.

Patient: That sounds like it would cause a lot of unnecessary stress and expense.

Dr. Malpani: Exactly. It not only creates unnecessary anxiety but also can lead to unnecessary, sometimes painful, interventions. If sperm is present in the semen, there’s no need for testicular surgery. It's a waste of your time and money, and it could even cause harm.

Patient: So, what should men do instead?

Dr. Malpani: If sperm is found in the semen, stick to a basic semen analysis. Avoid being pressured into unnecessary and invasive procedures. Don’t let anyone convince you to undergo testicular sperm aspiration unless it’s absolutely necessary.

Patient: Thank you, Dr. Malpani. This is very reassuring.

Dr. Malpani: You’re welcome. It's crucial to get accurate information before making any decisions.