The postcoital test is one of the oldest tests used in infertility diagnostics. It is performed after sexual intercourse with ejaculation into the uterus during the female’s ovulatory phase. If the test is performed too early or too late in the cycle, the result will be abnormal because, during this time, the cervical mucus is relatively dense and hard for the spermatozoa to pass through. Optimal conditions allowing the spermatozoa to pass through the mucus so that the PCT can occur only during the ovulation phase.
The postcoital test confirms the completion of sexual intercourse and identifies fertility disorders caused by the inability of the spermatozoa to pass through the cervical canal, usually due to the presence of antibodies that inactivate the sperm. The test also shows the level of estrogen production for that given phase of the cycle and the receptiveness of cervical mucus for a possible conception.
The examined couple should engage in sexual intercourse 6-12 hours before the actual test. The doctor then takes a small sample of the cervical mucus and examines it under a microscope. During the specific days of the cycle, the mucus should be clear, thin and in sufficient quantity. In the individual microscope field of view (FOV), the mucus is also analyzed for spermatozoa contents and spermatozoa motility.
At least 5 spermatozoa are visible from every FOV, and they are all actively moving directly through the mucus. This result implies that sperm production is sufficient and that the spermatozoa were transported to the correct place in the vulva and passed through the cervical mucus.
There are less than 5 sperms visible from every FOV, and they move little or chaotically. The result implies an immune cause of infertility (the presence of antibodies in the cervical mucus).
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