Post coital testing, the microscopic evaluation of cervical mucus following intercourse, is a test commonly used to determine whether numbers of sperm sufficient to fertilize an egg are reaching a woman's body. The test is often used to decide whether artificial insemination might be helpful in treating a couple's infertility.
A favorable result indicates that cervical mucus quality is satisfactory, the man produces good quality sperm, and that the sperm and mucus are compatible. Poor results may indicate that the test was performed at the wrong time of the menstrual cycle or semen may not have been deposited properly into the vagina, the man might not be producing an adequate number of active sperm, cervical mucus might be of insufficient or poor quality or there may be incompatibility between sperm and mucus.
The procedure
The couple has intercourse no less than two hours and no more than four hours before going to their RE specialist’s office. This test is usually done around the time of ovulation, normal between cycle days 12-15.
Unless otherwise instructed, the male should be abstinent (not ejaculate) for at least two days prior to the post coital test. After intercourse, the woman may clean her outer genitalia; however, she should not douche. Sometimes the pressure to have intercourse on demand proves too difficult and the male partner cannot “perform.” It happens to couples on occasion and if it does, just call the office to arrange for the procedure on another day.
The doctor or nurse will insert a speculum into the vagina and obtain, in a painless fashion, a sample of cervical mucus that will be viewed under a microscope. The results are available at the time of the visit. In a satisfactory test, at least five progressively moving sperm will be in each microscopic field. In a poor test, no active sperm will be seen. In a borderline test, between 1 and 5 motile sperm are seen per high power microscopic field.
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