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Postcoital Test

Test Overview

A postcoital test checks a woman's cervical mucus after sex to see whether sperm are present and moving normally. This test may be used if a woman is not able to become pregnant (infertility) and other tests have not found a cause.

The test is done 1 to 2 days before ovulation when the cervical mucus is thin and stretchy and sperm can easily move through it into the uterus. Within 2 to 8 hours after you have sex, your doctor collects and looks at a cervical mucus sample.

Many doctors question the value of the postcoital test to check for infertility. It is not done very often.

Why It Is Done

The postcoital test may be done if you are not able to become pregnant and:

  • You are ovulating, your fallopian tubes are not blocked, and your partner's sperm are normal. A problem with your cervical mucus may be causing infertility.
  • Immune system problems, such as sperm antibodies, may be a cause of infertility.
  • Your male partner does not want to be tested.

How To Prepare

The postcoital test must be done within 1 to 2 days of ovulation. Follow your doctor's instructions for checking your basal body temperature, cervical mucus, and the level of luteinizing hormone (LH) in your urine. When you check your LH level, do the urine test in the mid- to late morning, and do not drink any fluids that morning until you have done the test. If your test shows that you are ovulating, call for a doctor's visit for the next day.

Have sex about 2 to 8 hours before your visit. Do not use lubricants during sex. Do not douche or take a bath after sex, but you may take a shower.

Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information formmedical test information form(What is a PDF document?).

How It Is Done

A postcoital test is done in your doctor's office.

You will take off your clothes below the waist. You will have a gown to drape around your waist. You will then lie on your back on an examination table with your feet raised and supported by stirrups. This is similar to having a pelvic examination or Pap test.

Your doctor will insert a lubricated tool called a speculum into your vagina. The speculum gently spreads apart the vaginal walls, allowing your doctor to see the inside of the vagina and the cervix.

How It Feels

You may feel some discomfort when the speculum is put in.

Risks

A pelvic examination to collect a cervical mucus sample does not cause problems.

Results

A postcoital test checks a woman's cervical mucus after sex to see whether sperm are present and moving normally. Results of the postcoital test may be shared with you right after the test.

Postcoital test results1
Normal:
  • Normal amounts of sperm are seen in the sample.
  • Sperm are moving forward through the cervical mucus.
  • Mucus stretches a normal amount.
  • Mucus dries in a fernlike pattern.
Abnormal:
  • Mucus does not stretch.
  • Mucus does not dry in a fernlike pattern.
  • No sperm or a large number of dead sperm are seen in the sample.
  • Sperm are clumped together and not moving normally.

What Affects the Test

A postcoital test may not be normal if you do not know the exact day of ovulation. If the test is done at another time in your cycle, the sperm cannot move through your cervical mucus.

What To Think About

  • Clumped or dead sperm may mean that the cervical mucus has problems that affect the sperm or that you or your partner has developed antibodies against the sperm (immunologic infertility). To learn more, see the topic Antisperm Antibody Test.
  • If a postcoital test is abnormal, a sperm penetration test may be done. To learn more, see the topic Sperm Penetration Tests.
  • Many couples find it hard to have sex "on demand," especially when an examination must be done soon after having sex.
  • This test is not done very often, because experts feel the results do not always correctly indicate infertility.

To learn more, see the topic Infertility Testing.

References

Citations

  1. Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.

Other Works Consulted

  • Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders.
  • Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby.

Credits

By Healthwise Staff
Primary Medical Reviewer Sarah Marshall, MD - Family Medicine
Specialist Medical Reviewer Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology
Last Revised October 22, 2012

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