The Postcoital Test

The postcoital test (PCT) evaluates the interaction between the sperm and your cervical mucus at a time near ovulation.

About halfway through your menstrual cycle, you may notice a clear vaginal discharge. This is “fertile” mucus, produced by your cervix near the time you ovulate (release an egg from your ovary). The sperm must penetrate and swim through this mucus, then travel through the reproductive tract to reach the egg. Sometimes there is an incompatibility between the sperm and the cervical mucus, and the sperm become immobile or die. The reason this happens is not clear—the quality of the mucus may not enable the sperm to move well, or infections or antibodies in the mucus may kill the sperm. There may also be a problem with the sperm. Your doctor will examine the quality of your mucus and the interaction of the sperm with your mucus to determine if an incompatibility exists.

How this test is performed

The postcoital test (PCT) must be performed near the time you ovulate, so you and your doctor will need to estimate when your ovulation will take place. This is often difficult to do, especially if your cycle is irregular. The best way to know when ovulation will occur is to use an ovulation prediction kit that you can buy at the drugstore. The ovulation prediction kit measures the LH (luteinizing hormone) in your urine. A rise in your LH (also called an LH surge) means that you will probably ovulate within the next 24 to 36 hours. When you have an LH surge, you will need to schedule an appointment with your doctor for the next day. Plan to have sexual intercourse any time that day, before your appointment. The PCT is painless and takes only a few minutes—the procedure is similar to a Pap smear. Your doctor will collect a sample of your cervical mucus and examine it under a microscope to see the quality of the mucus and if the sperm are active or still.

Questions & Answers

Q. How soon before the test should we have sexual relations?
A. You may have intercourse any time after your LH surge. And, it is best to have intercourse within 12 hours before the test. Your doctor or nurse may give you more specific instructions.

Q. Is it okay to bathe or shower before having the test?
A. You may shower, but do not take a tub bath. Also, do not douche or put anything in your vagina.

Q. When will I get the results of the test?
A. Your cervical mucus will be examined immediately after it is collected, so your results should be available right away.

Q. Will I have to do this test more than once?
A. You may have to repeat this test if your results are abnormal or inconclusive. Timing is very important for this test — if it is done too early before ovulation, or too late afterward, your results may be inconclusive.

Q. A couple that I know told me they found this test stressful. Is that true for most couples?
A. Most couples feel this way about infertility testing in general, but the postcoital test places a lot of pressure on couples to have sexual relations at a specific time. The added stress often makes it difficult for men to perform and it’s not uncommon for couples to have to wait and try again during this cycle or the next one.

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