Postcoital testing examines cervical mucus for sperm activity after intercourse, but it is invasive and ineffective. Normal results show living sperm moving normally, while abnormal results may indicate immune system issues or incorrect ovulation timing. Many doctors prefer other fertility tests, such as laparoscopy and endometrial biopsy.
Postcoital testing is an infertility test in which cervical mucus is taken from a patient a few hours after intercourse and examined for sperm activity. Most of the time, a postcoital test will occur a day or two before ovulation, when conditions are most favorable for sperm. Sperm can usually live in cervical mucus for some time, so this test usually takes place a few hours after intercourse. Considered potentially invasive and ineffective, this test is often used late in the testing process if no other tests have explained a particular case of infertility.
Normal test results will have some characteristics. Levels of living sperm should be normal, and sperm should move through the mucus normally. The mucus should stretch about 2 inches (5 cm) and dry into a distinctive fern pattern on a microscope slide. These types of results could indicate that cervical mucus is a friendly environment for sperm. Postcoital testing can rule out some causes of infertility, including ovulation problems and the immune system’s effect on sperm.
Abnormal test results may show that many or all of the sperm are dead or clumped together and moving slowly through the mucus. Cervical mucus may not stretch and may not dry into a fern-like pattern on a microscope slide. These types of postcoital test results could indicate immune system issues, incorrect timing of ovulation, and other related factors. While this test can be useful in determining the influence of certain factors, it can also be considered ineffective.
Many doctors prefer not to use postcoital testing unless it is absolutely necessary to diagnose infertility. Some health professionals caution against testing except as a last resort. Many factors that can’t be controlled in the laboratory, such as ineffective coitus and timing of ovulation, can affect the results of a postcoital test.
Evidence-based medicine, on the other hand, can affect fertility and could improve a patient’s chances of fertility. Other fertility tests considered by many doctors long before considering postcoital testing include laparoscopy and endometrial biopsy. The range of fertility methods and infertility testing means that a postcoital test may not even provide useful results compared to the other procedures. Evidence-based medicine and other infertility testing methods are generally more effective, so many medical practices choose not to use postcoital testing to determine the cause of a patient’s infertility.
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