The postcoital test is considered an early component of a basic infertility evaluation. Cervical mucus affects the ability of sperm to penetrate through the cervix and result in fertilization. The secretion of cervical mucus is regulated by the ovarian hormones. Estrogen stimulates the production of large amounts of thin, clear mucus with increased stretchability and decreased cellularity. This type of mucus occurs immediately prior to ovulation and is favorable for sperm penetration. Cervical mucus protects sperm from the acidic vaginal environment, supplements the energy requirements of the sperm, functions as a filter to exclude abnormal and sluggish sperm, and serves as a reservoir to release sperm over a period of hours/days following intercourse. Progesterone results in increased thickness, cellularity, and increased difficulty for sperm penetration. A postcoital test provides a clinical assessment of the sperm-mucus interaction and penetration. Appropriate cycle timing is a critical factor for adequate postcoital test assessment. Documentation of findings should be accompanied by basal body temperature charts or LH color change. Poor results, despite appropriate timing, may be related to such factors as cervical factor abnormality, changes in vaginal acidity, cervical infection, or immune antibodies. Not every patient undergoing fertility testing will have this test done.

The easiest way to time a postcoital test is with ovulation predictor kits. Start your ovulation predictor kit as instructed by your physician. On the day of the color change call the office prior to 10 am to schedule a postcoital test for the following day. Have intercourse that evening after 10 pm, between 2 and 12 hours prior to the scheduled postcoital test. If you are concomitantly doing basal body temperature charts, bring your basal body chart to your scheduled appointment.

For a postcoital test the patient is placed in the lithotomy position (up in stirrups), and a speculum is inserted. The cervix is identified and the mucus is aspirated from the endocervical canal. The mucus is then examined on a microscope slide. Results of the slide will be available that day. If you have any questions with regard to timing your postcoital test, please call the office and speak to one of the nurses or physicians prior to scheduling your postcoital test appointment.

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