The postcoital test (PCT), also known as the Sims test, Hühner test ,Sims–Hühner test, or cervical mucous penetration assay is a test in the evaluation of

infertility In biology, infertility is the inability of a male and female organism to Sexual reproduction, reproduce. It is usually not the natural state of a healthy organism that has reached sexual maturity, so children who have not undergone puberty, whi ...

. The test examines interaction between

sperm Sperm (: sperm or sperms) is the male reproductive Cell (biology), cell, or gamete, in anisogamous forms of sexual reproduction (forms in which there is a larger, female reproductive cell and a smaller, male one). Animals produce motile sperm ...

and mucus of the

cervix The cervix (: cervices) or cervix uteri is a dynamic fibromuscular sexual organ of the female reproductive system that connects the vagina with the uterine cavity. The human female cervix has been documented anatomically since at least the time ...

. The PCT examines sperm survival in

cervical mucus The cervix (: cervices) or cervix uteri is a dynamic fibromuscular sexual organ of the female reproductive system that connects the vagina with the uterine cavity. The human female cervix has been documented anatomically since at least the tim ...

during the pre-ovulatory period and determines whether sperm are migrating into the female reproductive system. It does not predict whether pregnancy can occur. The test is performed 1 to 2 days before ovulation, when estrogen-stimulated cervical mucus is abundant.

Basal body temperature Basal body temperature (BBT or BTP) is the lowest body temperature attained during rest (usually during sleep). It is usually estimated by a temperature measurement immediately after awakening and before any physical activity has been undertaken. ...

s or the midcycle

luteinizing hormone Luteinizing hormone (LH, also known as luteinising hormone, lutropin and sometimes lutrophin) is a hormone produced by gonadotropic cells in the anterior pituitary gland. The production of LH is regulated by gonadotropin-releasing hormone (G ...

surge may be used to determine the timing of the PCT. Mucus is withdrawn from the endocervical canal within 8 hours of coitus and examined. The presence of any forwardly motile sperm in alkaline mucus suggests adequate coital technique and a normal cervical mucus–sperm interaction.

Procedure

The PCT is scheduled close to

ovulation Ovulation is an important part of the menstrual cycle in female vertebrates where the egg cells are released from the ovaries as part of the ovarian cycle. In female humans ovulation typically occurs near the midpoint in the menstrual cycle and ...

when mucus is abundant, and the infertile couple is asked to have

sexual intercourse Sexual intercourse (also coitus or copulation) is a sexual activity typically involving the insertion of the Erection, erect male Human penis, penis inside the female vagina and followed by Pelvic thrust, thrusting motions for sexual pleasure ...

, preferably in early hours of morning. Several hours later (usually 2), the woman is examined by the physician. The mucus is aspirated from cervical canal and spread on a glass slide. Smear from posterior fornix is used as control. 10-50 motile sperms per high power field are considered normal. Rotatory or shaky motion of sperms indicates presence of antispermal antibody. Cervical mucus is examined for quality, viscosity and

fern test The fern test is a medical laboratory test used in obstetrics and gynecology. The name refers to the detection of a characteristic "fern like" pattern of vaginal secretions when a specimen is allowed to dry on a glass slide and is viewed under a ...

.Padubidri; Daftary (2011). ''Shaw's Textbook of Gynaecology, 15e.'' p. 204. A poor PCT may indicate sperm or mucus problems, including perhaps presence of immune factors that inactivate sperm. Also ovulatory problems and poor coital technique may affect the PCT. The test is useless in presence of cervical infection. With the application of principles of

evidence-based medicine Evidence-based medicine (EBM) is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. It means integrating individual clinical expertise with the best available exte ...

the role of the PCT has been questioned and its use has become controversial.Pavone ME, Hirshfeld-Cytron JE, Kazer RR, 'The progressive simplification of the infertility evaluation.' Obstet Gynecol Surv. 2011 Jan;66(1):31-41.

History

It was apparently first performed by

J. Marion Sims James Marion Sims (January 25, 1813November 13, 1883) was an American physician in the field of surgery. His most famous work was the development of a Surgery, surgical technique for the repair of vesicovaginal fistula, a severe Complication (me ...

and later described by Max Huhner.

References

{{DEFAULTSORT:Postcoital Test Medical tests Female genital procedures Fertility medicine

Procedure

History

See also

References