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Hum. Reprod. Advance Access originally published online on April 7, 2004
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Human Reproduction, Vol. 19, No. 6, 1373-1379, June 2004
© 2004 European Society of Human Reproduction and Embryology

Should the post-coital test (PCT) be part of the routine fertility work-up?

Jan W. van der Steeg1,2,3,6, Pieternel Steures1,2,3, Marinus J.C. Eijkemans1, J. Dik Habbema1, Fulco van der Veen2, Patrick M.M. Bossuyt3, Peter G.A. Hompes4 and Ben W.J. Mol2,5

1 Department of Public Health, Erasmus Medical Center, Rotterdam, 2 Center for Reproductive Medicine and 3 Department of Biostatistics and Epidemiology, Academic Medical Center, Amsterdam, 4 Department of Obstetrics and Gynaecology, Vrije Universiteit Medical Center, Amsterdam and 5 Department of Obstetrics and Gynaecology, Máxima Medical Center, Veldhoven, The Netherlands

6 To whom correspondence should be addressed at: Erasmus Medical Center, University Medical Center Rotterdam, Department of Public Health, Room 2061, Dr Molewaterplein 50, 3015 GE Rotterdam, The Netherlands. e-mail: j.vandersteeg{at}erasmusmc.nl

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. CONCLUSION: The medical history and semen analysis can predict the result of the PCT in ~50% of the subfertile couples with a regular cycle, without compromising its potential to predict pregnancy.

Key words: model/PCT/pregnancy/prognosis/subfertility


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