title: The utility and cost of Chlamydia trachomatis and Neisseria gonorrhoeae screening of a male infertility population.
abstract: OBJECTIVE
  To determine the utility and cost of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) screening in infertile males.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Canadian tertiary-level male infertility clinic and university-affiliated laboratories.
  
  
  METHODS
  5,588 male infertility patients.
  
  
  METHODS
  CT and NG testing on 8,972 urine and semen samples.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Trustin
authors.initials: T
authors.lastname: Domes
authors.forename: Kirk C
authors.initials: KC
authors.lastname: Lo
authors.forename: Ethan D
authors.initials: ED
authors.lastname: Grober
authors.forename: J Brendan
authors.initials: JB
authors.lastname: Mullen
authors.forename: Tony
authors.initials: T
authors.lastname: Mazzulli
authors.forename: Keith
authors.initials: K
authors.lastname: Jarvi
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D002690:Chlamydia Infections / Q000150:complications / Q000175:diagnosis* / Q000191:economics* / Q000453:epidemiology / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D003362:Cost-Benefit Analysis; D006069:Gonorrhea / Q000150:complications / Q000175:diagnosis* / Q000191:economics* / Q000453:epidemiology / Q000382:microbiology; D017048:Health Care Costs; D006801:Humans; D007248:Infertility, Male / Q000175:diagnosis* / Q000191:economics* / Q000453:epidemiology / Q000382:microbiology; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000379:methods; D008875:Middle Aged; D018803:Models, Economic; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification*; D009864:Ontario / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence; D015397:Program Evaluation; D012189:Retrospective Studies; D055815:Young Adult