The postcoital test (PCT), also known as the Sims test, Huhner test or Sims–Huhner test, is a test in the evaluation of

infertility Infertility is the inability of a person, animal or plant to reproduce by natural means. It is usually not the natural state of a healthy adult, except notably among certain eusocial species (mostly haplodiploid insects). It is the normal state ...

. The test examines interaction between

sperm Sperm is the male reproductive 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 with a tail known as a flagellum, whi ...

and mucus of the

cervix The cervix or cervix uteri (Latin, 'neck of the uterus') is the lower part of the uterus (womb) in the human female reproductive system. The cervix is usually 2 to 3 cm long (~1 inch) and roughly cylindrical in shape, which changes during ...

. The PCT examines sperm survival in

cervical mucus The cervix or cervix uteri (Latin, 'neck of the uterus') is the lower part of the uterus (womb) in the human female reproductive system. The cervix is usually 2 to 3 cm long (~1 inch) and roughly cylindrical in shape, which changes during ...

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 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 Mucus is withdrawn from the endocervical canal within 8 hours of coitus and examined.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 when mucus is abundant, and the infertile couple is asked to have

sexual intercourse Sexual intercourse (or coitus or copulation) is a sexual activity typically involving the insertion and thrusting of the penis into the vagina for sexual pleasure or reproduction.Sexual intercourse most commonly means penile–vaginal penetrat ...

, 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 lo ...

.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". The aim of EBM is to integrate the experience of the clinician, the values of t ...

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 surgical technique for the repair of vesicovaginal fistula, a severe complication of obstruc ...

and later described by

Max Huhner Max or MAX may refer to: Animals * Max (dog) (1983–2013), at one time purported to be the world's oldest living dog * Max (English Springer Spaniel), the first pet dog to win the PDSA Order of Merit (animal equivalent of OBE) * Max (gorilla) (1 ...

Notes

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

Procedure

History

See also

Notes