Postcoital Test A postcoital test is used to assess a woman's cervical mucus after sex to see if sperm is present and moving naturally. This test may be used if a woman is believed to be infertile and other tests have not found a cause. The postcoital test may be done if: you are not able to become pregnant but you are ovulating, your fallopian tubes are open per a hysterosalpingogram (HSG) test, or if the sperm is normal. The immune system will also cause problems is there are sperm antibodies. You may not get valid result if you do not know the exact day of ovulation. If the test is not done at the correct time in your cycle, the sperm cannot move through your cervical mucus. The test is done one to two days before ovulation. During this time, the cervical mucus is thin and stretchy and sperm can easily move into the uterus. Within 2 to 8 hours after you have sex, your fertility doctor will collect and analyze the cervical mucus sample. When you check your LH level using an OPK to determine ovulation. If your test shows positive for ovulation, you will call for a doctor's visit for the next day. If you have a partner, you may be told to have sex 2 to 8 hours before your appointment. The test is then performed by using a speculum in order to collect the cervical mucus. The test checks the cervical mucus after sex to see whether sperm are present and moving normally. Usually results of the postcoital test may be shared with you right after the test. Some results you may get are: Normal

  • Normal amounts of sperm are seen in the sample.
  • Sperm are moving forward through the cervical mucus.
  • The mucus stretches at least 2 inches.

Abnormal

  • No sperm or a large number of dead sperm are seen in the sample.
  • Sperm are clumped together and not moving normally, they may be moving backwards, sideways or not at all.

Clumped or dead sperm may indicate that the cervical mucus is affecting the sperm or that you or your partner has developed antibodies against the sperm (immunologic infertility). Therefore another medical test called Antisperm Antibody Test or a sperm penetration test may be performed. The list could go on and on for how many test that could be performed to try & rule out possibilities for infertility. Some infertility tests include semen analysis, physical examination, and blood tests, which all do not cause pain. But some procedures, such as an endometrial biopsy, a laparoscopy, or a hysterosalpingogram (HSG), may cause pain. Infertility tests can also cost a lot and cause stress and anxiety. Some doctors even question the usefulness of the postcoital test, therefore it is not done very often. One study suggests routine use of the postcoital test in infertility investigations leads to more tests and treatments and has no major effect on pregnancy rates. However, in order to avoid this issue, having an intrauterine insemination (IUI) will bypass the cervical mucus. References Infertility & Reproduction Guide. (2008). WebMD. Retrieved from: http://www.webmd.com/infertility-and-reproduction/guide/postcoital-test Effectiveness of the postcoital test: randomized contoll trial. (1998). BMJ. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC28641/

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