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

ObjectiveTo determine the utility and cost of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) screening in infertile males.DesignCohort study.SettingCanadian 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.