Comparison of the fractional postcoital test and semen analysis

Abstract

This twofold investigation was designed to determine the prognostic value of the midcycle fractional postcoital test (PCT) in regard to the semen analysis (SA). The first portion of the study involved a comparison of the SA and PCT in 101 infertility couples. A significant correlation was noted between the number of motile sperm per high-power field at the internal cervical os level and the SA (p < 0.01). When the PCT contained more than 15 motile sperm per high-power field, the SA was usually greater than 20 × 106 sperm. Since the PCT and the SA were not collected from the same ejaculate, the second portion of the study was designed to alleviate this problem. Thirty-eight normal female subjects had midcycle cervical mucus collections after insemination of known amounts of sperm. With time held constant there was a significant correlation between the motile inseminated sperm and the number of cervical mucus sperm (p < 0.001). A median sperm count of 28 × 106 per cubic centimeter produced greater than 15 motile sperm per high-power field at the internal cervical os. Also a sperm count of 9 × 106 per cubic centimeter resulted in 11 to 12 motile sperm per high-power field, whereas only 3 × 106 resulted in 5 to 6 sperm per high-power field. Thus, while more than 5 motile sperm per high-power field are considered normal for the fractional PCT, an SA is still necessary for the infertility evaluation. Only when moer than 15 motile sperm per high-power field are noted at the internal cervical os level is repeated SA probably not necessary.