From the Research
The post-coital test (PCT) should be performed 1-2 days before expected ovulation, typically around day 12-14 of a 28-day menstrual cycle, as this timing is crucial for accurate results, according to the most recent study 1.
Post-Coital Test Timing
The test should be scheduled 2-12 hours after intercourse, with 8-12 hours being optimal.
- For the test, couples should have intercourse without using lubricants, and the woman should remain lying down for 15-30 minutes afterward to prevent semen leakage.
- The woman should then visit her healthcare provider, who will collect a sample of cervical mucus to examine sperm quantity, motility, and interaction with the mucus. This timing is crucial because near ovulation, estrogen levels peak, making cervical mucus more hospitable to sperm with increased stretchiness and alkalinity, as noted in earlier studies 2, 3.
Importance of Timing
Testing too early or too late in the cycle will yield inaccurate results as the mucus properties change throughout the menstrual cycle.
- Though less commonly used today due to advanced fertility testing options, the PCT can still provide valuable information about potential cervical factor infertility when properly timed, as supported by recent research 1.
- The prognostic value of the post-coital test has been studied prospectively, and time-specific conception rates were found to be inversely related to the number of motile sperm seen 4.
- However, other studies have found that postcoital sperm motility was a weak predictor of pregnancy, and regression analysis controlling for other potential predictors revealed no independent association between postcoital sperm motility and the later occurrence of pregnancy 5.
Clinical Application
Despite these findings, the PCT remains a useful tool in the evaluation of infertile couples, particularly when used in conjunction with other diagnostic tests.
- By following the recommended timing and protocol for the PCT, healthcare providers can gain valuable insights into the interaction between sperm and cervical mucus, and make more informed decisions about treatment options.
- As noted in the most recent study 1, the PCT can still provide valuable information about potential cervical factor infertility when properly timed, making it a useful tool in the development of new vaginal contraceptives.