Legacy Now Offers At-Home STI Testing

Khaled Kteily
6 min readAug 10, 2022

I’m always amazed by how opaque the US healthcare system is.

Despite growing up abroad, I spent years specialized in the Affordable Care Act, have spent about a decade around the healthcare space, and still have NO idea what to do, where to go, or how much I’m going to pay when I need healthcare. It’s honestly embarrassing, but I know I’m not alone in feeling this way.

This is one of the reasons why direct-to-consumer healthcare has taken off. For example, at Legacy, you pay $295 for a semen analysis, no hidden costs, no unexpected fees, no exorbitant and indecipherable bills. Simple!

I was reminded of this a few months back, when I decided to go in for a routine STI test.

First of all — where do you go? How do you sign up? Will insurance cover it? I honestly had no idea. I finally signed up for a nearby Quest Diagnostics, walked over, had to FAX (I kid you not) my insurance information to them. Literally — FAX!!!

When I met with the nurse, she curtly informed me that insurance would not cover the test, and she wasn’t sure how much it would cost, but likely around a thousand dollars, despite the fact that I had looked up my insurance coverage and was almost positive they would, in fact, cover it.

We finally sorted it out, although it took almost an hour until I could be seen, despite the fact that I had pre-paid for the visit. The visit was otherwise fairly uneventful — blood draw, urine sample, all went fine .In all, I wasted about 2 hours of my time that I could have spent doing just about anything else.

I got my results about a week later, except I didn’t get it all at once. Because I went in for a full screen, I got 11 text notifications for 11 different types of tests. Each time, the results were difficult to decipher, and of course, came with a minor jolt of worry each time that something had gone wrong.

This is a screenshot, from my phone, of just some of the test results that came back one by one. As if any of us know what “HEPATITIS B SURFACE ANTIGEN W/REFL CONFIRM” means.

It’s experiences like these that make me feel so proud when we’re able to launch a new product ourselves, with a streamlined user experience and easy-to-understand results, designed for real human beings.

We’ve made at-home testing easier for a more complete picture of your fertility health

You probably know why I started Legacy, but just in case, here is the basic story: Hot coffee in my lap. Second-degree burns. Weeks of anxiety about the long-term effects on my ability to start a family. One humiliating and dehumanizing sperm testing experience and the desire for no one to ever have to go through this experience again.

STI testing also features an embarrassing visit to the doctor. I want these tests to be something that isn’t just medically private (HIPAA laws ensure no one but you and your healthcare provider see your results) but also feels private. Our STI testing is completed in the privacy of your home on your own time, and you get both results and next steps in as few as five days from receiving your kit at the lab.

The Legacy STI Test Kit, pictured in Boston, MA. Look at that view!

Our at-home kit involves no extensive blood draws either. The urine sample tests for gonorrhea and chlamydia, and you receive clear instructions for producing the best sample. Our blood test — which detects hepatitis B and C, HIV, and syphilis — uses a finger-prick blood sample with clear instructions.

Unboxed: The Legacy at-home STI Testing Kit

We give you everything you need for proper sample collection, and our test is 99% accurate as long as we receive a quality sample. You receive Clinic-grade analysis in a CLIA-certified lab, and results displayed on your private, HIPAA-compliant results dashboard.

I can say this as a user — the experience is miles ahead of going to a clinic.

STIs can affect fertility health in the long term

The CDC estimates that 1 in 5 people in the United States has a sexually transmitted infection. Chlamydia, Trich, and Gonorrhea alone account for about 12.5M new infections each year (1M per month). Half of those infections are people between the ages of 15 to 24, making it most common for young people in what’s considered their prime to have an STI.

These STI infections can affect your long-term fertility picture. For example, people with chlamydia or gonorrhea are 35% more likely to experience DNA fragmentation in sperm than people without those infections. Both Herpes and AIDS are associated with negative semen parameters as well. HPV-positive people may also experience lower sperm production. And this doesn’t even include the future effects spreading disease to a partner could have on fertility planning.

Legacy wants to make sperm testing and storage more common and more accessible for young people because freezing sperm at our sexual peak helps make family planning easier in the future. However, STIs could add new fertility factors, especially the longer they continue untreated.

Making sperm testing easier helps improve fertility parameters

STI testing right now is an invasive and inconvenient thing to have done. If we want more people to test regularly for STIs, we have to improve the process. That’s what Legacy has done. Right now, STI testing is:

  1. Cumbersome — requiring an in-person visit to a clinic
  2. Slow — can take days or weeks to get an appointment
  3. Unenjoyable — requiring a blood draw
  4. Expensive — Quest charges $200 for a simple STD test and $380 for the expanded test

Plus, if you have a penis, you’re less likely to show symptoms of certain STIs, so you must get tested regularly if you’re sexually active. Legacy is including STI testing in all of our packages now because it’s that integral to the overall picture of your fertility.

STI testing and fertility planning go hand in hand

We hope that by making STI testing more accessible and more private, we can encourage you to test more often. These results help provide a better picture of your overall health as well as the next steps for improving fertility. In addition:

  • Routine STI testing helps ensure you never unknowingly pass on an infection to your partner. STIs not only affect your fertility but the health of your partner and even your unborn child. With Legacy, you know if you’re safe.
  • Fertility clinics often require STI panels before handling or storing any reproductive cells. Legacy’s sperm testing and freezing kits now come with STI tests, so you take care of those steps at the same time. For clients with STI-positive panels, different sperm freezing protocols can help mitigate STI effects.
  • STI testing before freezing ensures your samples can be used at any fertility clinic or medical practice you choose when you’re ready to begin your family.

We’ve said it once, and we’ll say it again: Having all the information you need to make fertility decisions right at your fingertips is the best way to help family planning end with good outcomes. Legacy continues to improve the process of sperm testing and freezing by including the peripherals like STI testing so that each decision you make is supported by excellent medical information and your latest results.

For more information about our STI testing kits — either alone or as part of your complete sperm health kit — visit Legacy here.

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Khaled Kteily

Khaled is the Founder & CEO of Legacy. Prev. at Harvard, the World Economic Forum, and UN Women.