Should the post-coital test (PCT) be part of the routine fertility work-up?
BACKGROUND
This study aimed to determine whether medical history and semen analysis can predict the result of the post-coital test (PCT).


METHODS
A previously reported data set of Dutch patients collected between 1985 and 1993 was used. Our study was limited to just patients with an ovulatory cycle. Data were complete for medical history, semen analysis and PCT. We performed logistic regression analysis to evaluate whether these factors could predict the result of the PCT (PCT model). Furthermore, we evaluated the additional contribution of the PCT in the prediction of treatment-independent pregnancy (pregnancy model).


RESULTS
Thirty-four percent (179 out of 522) had an abnormal PCT. The PCT model contained previous pregnancy [odds ratio (OR) 2.1; 95% confidence interval (CI) 1.3-3.5], semen volume (OR 0.88; 95% CI 0.77-0.99), sperm concentration (OR 0.96; 95% CI 0.94-0.97), sperm motility (OR 0.97; 95% CI 0.96-0.98) and sperm morphology (OR 2.7; 95% CI 1.2-6.8). The area under the ROC curve of the model was 0.81. In the pregnancy model, the result of the actual PCT could be replaced by the predicted result of the PCT model in about half of the couples, without compromising its predictive capacity.


CONCLUSIONS
The medical history and semen analysis can predict the result of the PCT in approximately 50% of the subfertile couples with a regular cycle, without compromising its potential to predict pregnancy.
van der Steeg
Jan W
JW
Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands. j.vandersteeg@erasmusmc.nl
Steures
Pieternel
P
Eijkemans
Marinus J C
MJ
Habbema
J Dik
JD
van der Veen
Fulco
F
Bossuyt
Patrick M M
PM
Hompes
Peter G A
PG
Mol
Ben W J
BW
D000328:Adult; D003075:Coitus; D016001:Confidence Intervals; D003955:Diagnostic Tests, Routine; D005260:Female; D006801:Humans; D007246:Infertility / Q000175:diagnosis*; D016015:Logistic Models; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011247:Pregnancy; D012372:ROC Curve; D012189:Retrospective Studies; D012661:Semen; D013076:Sperm Count; D013081:Sperm Motility; D013094:Spermatozoa / Q000166:cytology