EFFECTIVENESS OF THE POSTCOITAL TEST - RANDOMIZED CONTROLLED TRIAL

Objectives: To investigate the impact of the postcoital test on the pr egnancy rate among subfertile couples and on the number of other diagn ostic tests and treatments. Design: Randomised controlled study. Setti ng: A university and two non-university teaching hospitals in the Neth erlands. Subjects: New couples at infertility clinics, 1 March 1993 to 1 October 1995; randomisation to an intervention group (series of inf ertility investigations that include the postcoital test) or to a cont rol group (series excluding the test). Main outcome measure: Cumulativ e pregnancy rate. Results: Of 736 consecutive new couples, 444 fulfill ed the inclusion criteria and consented to participate (intervention g roup, 227; control group, 217). Treatment was given more often in the intervention group than in the control group (54% v 41%; difference 13 % (95% confidence interval 4% to 22%)). Yet cumulative pregnancy rates at 24 months in the intervention group (49% (42% to 55%)) and the con trol group (48% (42% to 55%)) were closely similar (difference 1% (-9. 0% to 9.0%)). Conclusion: Routine use of the postcoital test in infert ility investigations leads to more tests and treatments but has no sig nificant effect on the pregnancy rate.