The utility and cost of Chlamydia trachomatis and Neisseria gonorrhoeae screening of a male infertility population

Fertil Steril. 2012 Feb;97(2):299-305. doi: 10.1016/j.fertnstert.2011.11.024. Epub 2011 Dec 21.


Objective: To determine the utility and cost of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) screening in infertile males.

Design: Cohort study.

Setting: Canadian tertiary-level male infertility clinic and university-affiliated laboratories.

Patient(s): 5,588 male infertility patients.

Intervention(s): CT and NG testing on 8,972 urine and semen samples.

Main outcome measure(s): Prevalence of CT and NG infection in infertile males versus general male population in Canada over 8 years (2003-2010) and the reagent cost to detect one case of CT or NG.

Result(s): In infertile males, the prevalence rate for CT and NG was 0.304% and 0.0537%, which was statistically significantly lower (3.4- and 8.1-fold lower, respectively) than the age-adjusted general population prevalence. With the reagents costing $86.20 per patient tested, the reagent cost alone to diagnose one case of CT or NG was $38,669.

Conclusion(s): The prevalence of CT and NG in this study are among the lowest reported in the male infertility literature. These findings question the utility of CT/NG screening in this low-risk population and emphasize that decisions about the utility of screening must be based on the prevalence rates of the disease in the studied population.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Chi-Square Distribution
  • Chlamydia Infections / complications
  • Chlamydia Infections / diagnosis*
  • Chlamydia Infections / economics*
  • Chlamydia Infections / epidemiology
  • Chlamydia Infections / microbiology
  • Chlamydia trachomatis / isolation & purification*
  • Cost-Benefit Analysis
  • Gonorrhea / complications
  • Gonorrhea / diagnosis*
  • Gonorrhea / economics*
  • Gonorrhea / epidemiology
  • Gonorrhea / microbiology
  • Health Care Costs*
  • Humans
  • Infertility, Male / diagnosis*
  • Infertility, Male / economics*
  • Infertility, Male / epidemiology
  • Infertility, Male / microbiology
  • Male
  • Mass Screening / economics*
  • Mass Screening / methods
  • Middle Aged
  • Models, Economic
  • Neisseria gonorrhoeae / isolation & purification*
  • Ontario / epidemiology
  • Predictive Value of Tests
  • Prevalence
  • Program Evaluation
  • Retrospective Studies
  • Young Adult