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Post-Coital Test of Limited Value
Title:Effectiveness of the post-coital test: randomized controlled trial
Author: S. Oei et al
Address: Veldhoven, Netherlands
Source: British Medical journal 317: 502-505 (August) 1998
Summary: This study included 444 sub fertile couples. 227 couples were assigned to an intervention group, a group that underwent post-coital testing and 217 were assigned to a control group that did not receive post-coital testing. Infertility investigation followed this randomization. The results showed that treatment for infertility was given more often to the intervention group than to the control group (54% vs. 41% ) but the main outcome measure, the cumulative pregnancy rate, was 49% in the intervention group vs 48% in the control group. The authors concluded that the routine use of post-coital testing in infertility investigations leads to more tests but has no significant effect on the pregnancy rate.
comment: The PCT is easy, relatively cheap, not terribly intrusive. Certainly, the greater quantity, the more elastic and the clearer the cervical mucus, the better.The problem is that it has little correlation to either a diagnosis, therapy, or prognosis. If motile sperm are seen, it indicates that the male partner is producing some sperm, but a formal semen analysis, is much more informative. Cervical mucus is a good bioassay of estrogen production, usually from a preovulatory follicle. But overall, it is a relatively poor indicator of ovulation. Most poor post coital tests are a result of poor timing, poor follicular development, or poor semen parameters. There are better ways to test for each of these parameters. The cervical mucus is hostile except for a very limited time around ovulation. Dead sperm do not mean sperm antibodies or a problem with the cervix. Cervical factors represent a small fraction of causes of infertility. The above is the second publication to come to the same conclusion.
Index for entries posted 10/22/98:
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