How much infertility does chlamydia cause?
Infertility due to obstruction of the fallopian tubes is one of the main severe and lasting consequences of infection with the bacterial sexually transmitted infections gonorrhoea and chlamydia. The disutility and costs associated with infertility and its treatment provide a substantial contribution to the assumed costs of chlamydia in the health economic analyses justifying chlamydia control programmes.1 However, infertility is difficult to define and measure.2 A lower bound on infertility is provided by medical diagnosis, which requires both that patients seek help and that diagnosis is available. More cases are added if we include all those seeking care for infertility or who believe they are infertile.2 Such measures might represent those for whom infertility is a problem, but they will greatly underestimate the true rates of infertility. An alternative is to look at birth histories and periods without any pregnancies, but such methods only readily apply to populations where contraception is not practised.3 A final method is to estimate the risks of infertility associated with different causes and calculate expected rates.4 This approach is generally adopted in health economic analyses5 where the proportion of infections leading to disease and the proportion of these that result in infertility is estimated. …
