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Human Reproduction, Vol. 10, No. 1, pp. 85-90, 1995
© 1995 European Society of Human Reproduction and Embryology

In-vitro cervical mucus — sperm penetration tests and outcome of infertility treatments in couples with repeatedly negative post-coital tests

J. Farhi, A. Valentine, G. Bahadur, F. Shenfield, S.J. Steele and H.S. Jacobs1

Division of Endocrinology, Department of Medicine, UCL Medical School, The Middlesex Hospital London, UK

Correspondence: 1To whom correspondence should be addressed at: The Cobbold Laboratories, The Middlesex Hospital, Mortimer Street, London WIN 8AA, UK

The results of in-vitro cervical mucus—sperm penetration tests and cross-hostility tests in 178 couples with repeatedly negative post-coital tests were recorded. Using a protocol of three cycles with intra-uterine inseminations (IUI) followed by three cycles with ovulation induction + IUI, the association between the cause of infertility, results of the in-vitro tests and the outcome of infertility treatment was investigated. We found that repeatedly negative post-coital tests are a good indicator of a cervical mucus — sperm penetration problem. The crosshostility test clearly differentiates the abnormal factor in this interaction, and a good performance of the donors' spermatozoa in the cervical mucus correlates with increased pregnancy rate. In male factor infertility, failure of the husbands' spermatozoa to penetrate cervical mucus was not indicative of a deficient fertilization potential in vivo. In these patients a serious attempt should therefore be made to reverse the infertility by treatment with IUI or ovulation induction + IUI before attempting assisted reproduction. Women with polycystic ovaries and repeatedly negative post-coital tests should be investigated for sperm receptivity of the cervical mucus. Low receptivity of the cervical mucus may imply that endometrial receptivity and oocyte quality are also low. Ovulation induction and not IUI alone should therefore be used as the preferred mode of treatment to improve pregnancy rate.

Key words: cross-hostility test/male factor/polycystic ovaries/post-coital test

Submitted on June 21, 1994; accepted on August 17, 1994.


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S. Tang, C. Garrett, and H.W.G. Baker
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Hum. Reprod., November 1, 1999; 14(11): 2812 - 2817.
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