title: Does the postcoital test predict pregnancy in WHO II anovulatory women? A prospective cohort study.
abstract: OBJECTIVE
  To assess the capacity of the postcoital test (PCT) to predict pregnancy in WHO II anovulatory women who are ovulatory on clomiphene citrate (CC). In these women, an abnormal PCT result could be associated with lower pregnancy chances, but this has never been proven or refuted.
  
  
  METHODS
  Prospective cohort study was performed between December 2009 and September 2012 for all women who started ovulation induction with CC in one university clinic and two teaching hospitals in the Netherlands. A PCT was performed in one of the first three ovulatory cycles. Ovulation induction with CC was continued for at least six cycles. The PCT was judged to be positive if at least one progressive motile spermatozo was seen in one of five high power fields at 400× magnification. The primary outcome was time to ongoing pregnancy, within six ovulatory cycles.
  
  
  RESULTS
  In 152 women the PCT was performed. 135 women had a reliable, well-timed PCT. The ongoing pregnancy rate was 44/107 (41%) for a positive and 10/28 (36%) for a negative PCT. The hazard rate for ongoing pregnancy was 1.3 (95% CI 0.64-2.5) for a positive versus a negative PCT. Thirty five of 77 (46%) women with clear mucus had an ongoing pregnancy versus 12 of 45 (27%) women in whom the mucus was not clear (HR 2.0; 95% CI 1.02-3.84, p=0.04).
  
  
  CONCLUSIONS
  The present study suggests that the outcome of the postcoital test in women with WHO-II anovulation that undergo ovulation induction with CC does not have a large effect on ongoing pregnancy chances over time.
authors.affiliation: Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, Academic Medical Center, University of Amsterdam, The Netherlands; Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, VU Medical Center, The Netherlands. Electronic address: marleennahuis@hotmail.com.
authors.forename: Marleen J
authors.initials: MJ
authors.lastname: Nahuis
authors.affiliation: Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, Academic Medical Center, University of Amsterdam, The Netherlands.
authors.forename: Nienke S
authors.initials: NS
authors.lastname: Weiss
authors.affiliation: Department of Obstetrics and Gynaecology, Medisch Spectrum Twente Hospital Group, Enschede, The Netherlands.
authors.forename: Minke
authors.initials: M
authors.lastname: Van der Velde
authors.affiliation: Department of Obstetrics and Gynaecology, Antonius Ziekenhuis, Utrecht, The Netherlands.
authors.forename: Jur J E
authors.initials: JJ
authors.lastname: Oosterhuis
authors.affiliation: Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, VU Medical Center, The Netherlands.
authors.forename: Peter G A
authors.initials: PG
authors.lastname: Hompes
authors.affiliation: Department of Obstetrics and Gynaecology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
authors.forename: Eugenie M
authors.initials: EM
authors.lastname: Kaaijk
authors.affiliation: Medical School Twente, Medisch Spectrum Twente, Enschede, The Netherlands; Department of Research Methodology, Measurement and Data Analysis, University of Twente, Enschede, The Netherlands.
authors.forename: Job
authors.initials: J
authors.lastname: van der Palen
authors.affiliation: Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, Academic Medical Center, University of Amsterdam, The Netherlands.
authors.forename: Fulco
authors.initials: F
authors.lastname: van der Veen
authors.affiliation: The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Australia.
authors.forename: Ben Willem J
authors.initials: BW
authors.lastname: Mol
authors.affiliation: Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, Academic Medical Center, University of Amsterdam, The Netherlands.
authors.forename: Madelon
authors.initials: M
authors.lastname: van Wely
mesh_terms: D000328:Adult; D000858:Anovulation / Q000188:drug therapy*; D002996:Clomiphene / Q000627:therapeutic use*; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D006801:Humans; D009426:Netherlands; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D011258:Pregnancy Tests / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D005300:Fertility Agents, Female; D002996:Clomiphene
keywords: Clomiphene citrate; Ovulation induction; Polycystic ovary syndrome; Postcoital test