When to Test His Fertility

Postcoital Test
If the semen analysis is normal, the next step should be a post-coital test. The postcoital test (also known as the Huhner Test) is one means of assessing the interaction of the sperm and the cervical mucus. In order to reach the fallopian tube and fertilize an egg therein, the sperm must first migrate through the cervical mucus. There are many factors that can impair the ability of the sperm to survive that journey, including faulty intercourse (for example: premature ejaculation), infection, prior surgery on the cervix, and production of antibodies (substances that can kill or immobilize the sperm).

During a normal menstrual cycle, there are only a couple of days during which the sperm can survive in the cervical mucus. At other times of the cycle, the mucus is a very effective barrier. Around the time of ovulation, the cervical mucus becomes very thin and watery, and probably even somehow assists the sperm as they migrate through to the uterus and on to the fallopian tubes. The timing of this test is, therefore, crucial. If a woman's cycles are regular, an ovulation predictor test can be used. If she is on medication or has very irregular cycles, the timing of this test should be discussed with your physician, but must always be just prior to ovulation.

Have intercourse the morning of the post-coital test. Do not use lubricants or douche or take a bath after intercourse (showers are fine). Note the approximate time of intercourse since that is important in evaluating the results. Although some authors state that this test must be done within two hours of intercourse, this is not important. Simply note how long it has been and notify your physician—they can adjust their interpretation based on the length of time.

In the office, a speculum exam is performed. A small amount of cervical mucus is withdrawn from the cervix (this is painless). This is then examined under the microscope. The quality of the cervical mucus as well as the number of sperm present and their motility will be assessed. You should be able to know the results right away.