Is this the best test for lyme and babesia?

I have had lyme for 2 1/2 years now and wanted to do a detailed testing now to see what my blood shows before my wife and I try for kids in 10 months or so(crossing fingers). I told my LLMD this and he sent me the following:

- NutrEval (Genova Labs)
- Igenex:
1. Babesia duncani IFA
2. Babesia Fish
3. IgXSpot Panel 1

I've only ever tested through labcorp and lyme has never come out positive while my babesia-duncani has almost always came out "1:256 Abnormal".

These are all out of pocket so I do want to be smart/ pick the best tests. Anyone know if these are the best tests and if not which one's would be the best?

to my knowledge FISH and IFA tests are usually recommended as suitable tests for Babesia
however none of the available tests are perfect and there are many issues - mainly to do with sensitivity

as I understand it there are two main issues driving the lack of sensitivity ( or high false negative rate _ ie a high chance of getting a negative result despite being infected )

1- once chronic, these infections are characterized by extremely low levels of infected cells in the blood most of the time - often less than 1 in 1000 red blood cells in a sample are infected - this means that the chance of infection being detected in your sample, even if you are indeed infected, is much lower than we would like.

2- there are a number of babesia organisms out there in the wild and several/many can infect humans - however, the serological tests mentioned only look for antibodies to 2 main species ( microti and divergens ) - this means that even though you might be infected and producing detectable antibodies - the tests do not necessarily look for antibodies to teh species you are infected with and will therefore report a negative result.

this link gives a pretty good explanation
https://www.treatlyme.net/guide/how-to-diagnose-babesia


testing for pretty much all tick-borne pathogens is plagued by this kind of issues....

as a result, the two general approaches that people follow are:

1, diagnose by clinical signs symptoms, and history - usually via an experienced LLMD
2, run multiple tests - each using a different methodology so that you improve your overall chances of getting a positive result

there are of course issues with both of these approaches - but until better tests are developed - this is the state of play at present.