A postcoital test checks a woman’s cervical mucus after sex to see whether sperm are present and moving normally. This test may be used if a woman is not able to become pregnant (infertility) and other tests have not found a cause. The test is done 1 to 2 days before ovulation when the cervical mucus is thin and stretchy and sperm can easily move through it into the uterus. Within 2 to 8 hours after you have sex, your doctor collects and looks at a cervical mucus sample.
The PCT is scheduled close to ovulation when mucus is abundant, and the infertile couple is asked to have sexual intercourse, preferably in early hours of morning. Several hours later (usually 2), the woman is examined by the physician. The mucus is aspirated from cervical canal and spread on a glass slide. Smear from posterior fornix is used as control.
Why It Is Done
The postcoital test may be done if you are not able to become pregnant and:
- You are ovulating, your fallopian tubes are not blocked, and your partner’s sperm are normal. A problem with your cervical mucus may be causing infertility.
- Immune system problems, such as sperm antibodies, may be a cause of infertility.
- Your male partner does not want to be tested.
How To Prepare
The postcoital test must be done within 1 to 2 days of ovulation. Follow your doctor’s instructions for checking your basal body temperature, cervical mucus, and the level of luteinizing hormone (LH) in your urine. When you check your LH level, do the urine test in the mid- to late morning, and do not drink any fluids that morning until you have done the test. If your test shows that you are ovulating, call for a doctor’s visit for the next day.
Have sex about 2 to 8 hours before your visit. Do not use lubricants during sex. Do not douche or take a bath after sex, but you may take a shower.
Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form.
How It Is Done
A postcoital test is done in your doctor’s office.
You will take off your clothes below the waist. You will have a gown to drape around your waist. You will then lie on your back on an examination table with your feet raised and supported by stirrups. This is similar to having a pelvic examinationor Pap test.
Your doctor will insert a lubricated tool called a speculum into your vagina. The speculum gently spreads apart the vaginal walls, allowing your doctor to see the inside of the vagina and the cervix. See a picture of the vaginal speculum examination.
How It Feels
You may feel some discomfort when the speculum is put in.
Results
A poor PCT may indicate sperm or mucus problems, including perhaps presence of immune factors that inactivate sperm. Also ovulatory problems and poor coital technique may affect the PCT. The test is useless in presence of cervical infection.[1]”Padubidri; Daftary (2011). Shaw’s Textbook of Gynaecology, 15e. p. 204. ISBN 9788131225486″. A favorable result would find many sperm in thin watery mucus, with good forward, active motion through the mucus. 10-50 motile sperms per high power field are considered normal. Rotatory or shaky motion of sperms indicates presence of antispermal antibody. Cervical mucus is examined for quality, viscosity and fern test.[2]”Padubidri; Daftary (2011). Shaw’s Textbook of Gynaecology, 15e. p. 204. ISBN 9788131225486“ If the initial test is good, a second delayed exam (18-24 hours after intercourse) may be required if infertility persists. If the initial test is poor, a repeat exam carried out 2-3 hours after intercourse may be needed.
Controversy
With the application of principles of evidence-based medicine the role of the PCT has been questioned and its use has become controversial.[3]”Pavone ME, Hirshfeld-Cytron JE, Kazer RR, ‘The progressive simplification of the infertility evaluation.’ Obstet Gynecol Surv. 2011 Jan;66(1):31-41. PMID 21510910″ Many doctors question the value of the postcoital test to check for infertility. It is not done very often.
Referenced Studies:
Dr. Kooner is Deputy Director of The Advanced Fertility Center of Chicago and has been a Specialist in Fertility Treatment since 1999.
As well as the areas that the clinic specialises in general, he is particularly interested in managing oocyte donation, female same-sex couples, single women having sperm donation and those considering egg freezing.
Dr. Kooner regularly speaks at fertility meetings. He has published in national journals and constantly contributes to the fertility research and publications from Advanced Fertility Center of Chicago.
References
| ↑1 | ”Padubidri; Daftary (2011). Shaw’s Textbook of Gynaecology, 15e. p. 204. ISBN 9788131225486″ |
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| ↑2 | ”Padubidri; Daftary (2011). Shaw’s Textbook of Gynaecology, 15e. p. 204. ISBN 9788131225486“ |
| ↑3 | ”Pavone ME, Hirshfeld-Cytron JE, Kazer RR, ‘The progressive simplification of the infertility evaluation.’ Obstet Gynecol Surv. 2011 Jan;66(1):31-41. PMID 21510910″ |
