Post-coital testing and endometrial testing are done only in select cases and are not considered as part of standard fertility testing.
Post Coital Testing
The postcoital test (PCT) is a test in the evaluation of infertility.
A postcoital test checks a woman’s cervical mucus after intercourse to see whether sperms are present and moving normally. This test may be used if a woman is not able to become pregnant (infertility) and other tests have not found a fertility problem.
This test is typically performed 1 to 2 days prior to ovulation when the cervical mucus is thin and stretchy so that sperm can easily filter through to reach higher up searching for the egg in the fallopian tubes. Your doctor will microscopically examine a cervical mucus sample collected within 2-8 hours after intercourse. The test is a good positive test, which means it rules out sperm delivery problems if healthy, sufficient, moving sperms are found. However, the validity of a negative test is questionable.
Endometrial lining assessment can be done in select cases and is not considered as a part of standard fertility testing.
An endometrial biopsy is a test that evaluates the endometrial tissue that lines the inside walls of your uterus. The quality of this tissue can be important in predicting success of implantation of an embryo. Around the time that you ovulate (release an egg from your ovary), your endometrium (inside lining of your uterus) grows thicker withthe development of blood vessels, glands, and stored nutrients to allow an early embryo to implant and grow. If fertilization does not occur, the endometrial tissue sheds as menstrual flow to mark the beginning of your next cycle.
Progesterone and estrogen control the growth and stabilization of the endometrial tissue. If your ovary doesn’t produce enough of these hormones, your uterus may not be able to maintain a pregnancy.
An endometrial biopsy is taken by your doctor and then sent to a pathologist who will examine the collected sample of your endometrial tissue under a microscope. Your doctor can tell if your endometrium is getting enough of these hormones by judging the thickness and cellular pattern of the cells obtained from the endometrial biopsy. If your body is not producing enough hormones, as judged by the histologic appearance of the endometrium, hormonal supplementation can then be prescribed to correct the defect, and ultimately improve the lining of your uterus.
Chronic inflammation of the endometrium will also be treated if diagnosed in the biopsy sample so that implantation chances can improve.