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

Capsule:
Extremely low prevalence rates of Chlamydia trachomatis and Neisseria gonorrhoeae infection were found in Canadian infertile men.

Authors:
Trustin Domes, M.D., Kirk C. Lo, M.D., Ethan D. Grober, M.D., J. Brendan Mullen, M.D., Tony Mazzulli, M.D., Keith Jarvi, M.D.
Volume 97, Issue 2 , Pages 299-305, February 2012

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.

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