Postcoital test

Gysler M, March CM, Mishell DR Jr, Bailey EJ. A decade s experience with an individualized clomiphene treatment regimen including its effect on the postcoital test. Fertil Steril 1982 37(2) 161-7. 

Mauck, C. K., Baker, J. M., Barr, S. P, Abercrombie, T. J., and Archer, D. F. (1997), A phase I comparative study of contraceptive vaginal films containing benzalkonium chloride and nonoxynol-9. Postcoital testing and colposcopy, Contraception, 56,89-96. 

Sperm Function. Functional tests have yet been established that can unequivocally predict the fertilizing capacity of spermatozoa. However, detailed methods describing the analysis of sperm function exist in the current literature. These methods attempt to measure the functions of sperm necessary for fertilization. For a sperm to be successful, it must be able to (1) reach the ova through directed motility, (2) undergo capacitation, (3) fuse with the oocyte membrane, and (4) be incorporated into the oocyte cytoplasm. The postcoital test (as described in the later section on evaluation of female infertility) is the most widely used measure of sperm adequacy. The WHO has accepted and offered guidelines for the postcoital test and the sperm-mucus penetration The sperm-mucus penetration... 

The initial evaluation of female infertility should include a detailed history and physical examination, including a Papanicolaou cervical and vaginal smear with appropriate cervical and endocervical cultures, a search for tubal patency and endometriosis or adhesions, and assessment of ovulation and adequate luteal function.After obvious treatable abnormalities have been excluded, a menstrual history indicates further endocrine evaluation and a postcoital test helps to determine coital snfticiency (Figure 53-16 see also earlier section on irregular menses). 

Corsan GH, Blotner MB, Bohrer MK, Shelden R, Kemmann E. The utility of a home urinary LH immunoassay in timing the postcoital test. Obstet Gynecol 1993 81 736-8. 

Eimers JM, te Velde ER, Gerritse R, van Kooy RJ, Kremer J, Habbema JD. The validity of the postcoital test for estimating the probability of conceiving. Am J Obstet Gynecol 1994 171 65-70. 

Oei SG, Keirse MJ, Bloemenkamp KW, Hehnerhorst EM. European postcoital tests Opinions and practice. Br J Obstet Gynaecol 1995 102 621-4. 

The adverse effects associated with clomiphene include thickening of the cervical mucus, which creates a substantial barrier for motile sperm. A postcoital test can be performed to determine if this, in fact, represents an insurmountable hurdle. If so, an lUI is warranted to bypass this cervical challenge. Another adverse effect is endometrial thinning, which is not conducive to embryo implantation if this is the case, additional pharmacological therapies are recommended to thicken the endometrial lining. Other adverse effects include hot flashes and mood swings (95). 

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