Postcoital Test (Sims-Huhner Test)

CHAPTER 154 Postcoital Test (Sims-Huhner Test)



Julie M. Sicilia


The postcoital test (PCT) is an evaluation of the survival and motility of sperm in the cervical mucus. The PCT is a way of detecting if sperm are present in the ejaculate and cervical mucus; it is not a diagnostic test for cervical factor infertility. The PCT should be used in conjunction with semen analysis, not as a substitute for it. Result validity has been questioned because of the lack of reproducibility and universal standards for obtaining and interpreting samples with the PCT. The PCT was previously a routine test in the infertility evaluation. A 1998 randomized controlled trial concluded that routine PCT for infertile couples increased the amount of testing but did not increase the pregnancy rate for the couples. Currently, the PCT is used only for guiding treatment decisions for couples with certain indications.



Indications



• Investigation of the sperm and cervical mucus interaction

• Monitoring the cervical mucus during the first ovulatory cycle of treatment with clomiphene citrate for couples planning timed intercourse infertility treatment

• To assist in deciding if a couple is a candidate for expectant management versus aggressive therapy (intrauterine insemination [IUI] or in vitro fertilization [IVF]) with suspected cervical factor infertility


Contraindications



• Any condition that would preclude unprotected sexual intercourse followed by examination and sampling of the cervix

• Active vaginal infection


Equipment



• Nonsterile examination gloves

• Vaginal speculum (no lubricant) and swabs

• Tuberculin syringe with cap

• Ring forceps

• Microscope, slides, and coverslips

• Plastic endometrial aspirator (optional)


Preprocedure Patient Education



• One month prior to PCT, have patient start measuring basal body temperature (BBT) or urinary luteinizing hormone (LH) ovulation testing. Review the BBT or LH graphs to determine the proper timing of intercourse. Have the patient watch for clear cervical mucus (more estrogenic). (See Chapter 150, Fertility Awareness–Based Methods of Contraception [Natural Family Planning].) The PCT should be performed as near as possible to ovulation. The test is usually performed on day 12 to 14 of an ideal 28-day cycle.

• Instruct the couple to abstain from intercourse or masturbation for 48 hours before the test. Before performing the PCT, determine that the BBT is in accord with the proper timing of the menstrual cycle for the performance of the test. Nothing (lubricants, medications, douches, etc.) should be placed in the vagina for 24 hours prior to the test and up to the time of the PCT.

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May 14, 2017 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Postcoital Test (Sims-Huhner Test)

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