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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:

  • Incorrect timing of the test 
  • Cycles where ovulation is not occurring
  • A low or even zero sperm count 
  • 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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