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Post-Coital
Test
What is the post-coital
test
The post-coital test assesses the
ability of sperm to reach the canal of the cervix and survive in the mucus.
One of the signs that a woman is ovulating is that there is a noticeable
change in the mucus secretion. At the time of ovulation, the ovaries produce
more estrogen as a result of which the mucus secreted by the cervix of
the uterus becomes very profuse, clear and watery like saliva. The cervical
mucus also becomes more receptive to sperm.
When should I take
the post-coital test
A post-coital test will be performed
at the clinic and will be scheduled as close to the time of ovulation as
possible. Previous basal body temperature charts can help to ascertain
the time of ovulation. It will be necessary for you to have intercourse
around eight hours before the test is performed.
Isn't intercourse "on
demand" very stressful
Being required to schedule your sexual
intercourse can put undue pressure on both you and your partner. Some couples
find that they just cannot seem to go through with intercourse in such
a clinical fashion. Some husbands have even failed to achieve an erection.
This, in turn, increases anxiety and tension. Remember that the clinic
has merely made a request. Men often find it easier to comply with this
request if they have been involved in the investigations and other procedures
right from the start.
How is the test carried
out
A speculum is gently inserted into
the vagina, and a sample of mucus is taken from the canal of the cervix.
It is a painless procedure that lasts for just a few seconds. The mucus
sample is then transferred onto a glass slide. While this is being done
the "stretchability" of the mucus is noted. The mucus sample is then examined
under a microscope. The sperm population is counted and their degree of
activity assessed.
How are the post-coital
test results analyzed
A completely normal post-coital test
will show very flowing "stretchable" mucus containing a significant number
of moving sperm. The sperm must be normal in appearance and moving across
the slide and not simply shaking on the spot. A post-coital test of this
quality implies that the sperm count is normal, that the sperm are gaining
access to the canal of the cervix and that there is no major cervical mucus
hostility factor.
Mucus with fewer sperm does not necessarily
mean that there is a problem. However, there is a greater probability that
pregnancy will occur when the sperm population is higher.
When is a post-coital
test considered negative
A post-coital test is considered
negative if no sperm or only dead sperm can be found in the mucus. This
does not mean that conception is impossible. It merely indicates the need
for further investigation. Sometimes the mucus itself is very thick and
tenacious rather than watery and flowing. A negative post-coital test may
be due to:
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Incorrect timing of the test
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Cycles where ovulation is not occurring
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A low or even zero sperm count
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Antibodies preventing progressive movement
of the sperm. These may be present in the mucus itself or even in the seminal
fluid carrying the sperm
If your post-coital test is found to
be negative, it will probably be repeated. If the repeat test should still
be negative, then other tests (see below) may be necessary.
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