EVALUATION OF THE POSTCOITAL TEST FOR ASSESSMENT OF CERVICAL FACTOR INFERTILITY

Objective: To evaluate the test properties of the postcoital test (PCT ). Study Design: Retrospective analysis of prospectively collected dat a on a cohort of infertile couples with complete follow up. Setting: F ertility clinic of a Dutch university hospital. Subjects: A continuous series of 224 couples of whom 24 were excluded for reasons of anovula tion, coital problems, proven sterility or incomplete follow-up. Analy sis: Cumulative pregnancy rates in relation to PCT results with and wi thout treatment for 'cervical factor' infertility. Results: The predic tive values of normal and abnormal PCTs were 0.54 and 0.58 overall and 0.74 and 0.47 if only untreated women were considered. Sensitivity an d specificity were, respectively, 0.47 and 0.65 for all women and 0.54 and 0.68 for untreated women only. Likelihood ratios for normal and a bnormal PCTs were 0.83 and 1.32 overall and 0.67 and 1.72 in untreated women. Conclusion: The PCT has poor predictive power. This and the ps ychological impact on subfertile couples attest to the need for more r igorous study designs in evaluating this test.