Both my husband and I have undergone a number of infertility tests (sperm analysis, progesterone, HSG, and postcoital test). So far, all tests results are normal, except the postcoital test, which gives poor results (very poor sperm motility in the cervical area). The test was timed by using an LH test kit, so timing wasn't a problem. Does this indicate the presence of antibody? Do we need to have the test repeated? My OB/GYN suggests artificial insemination. I'm wondering whether more tests are needed. What's your view? --Julia

We find that the postcoital test (PCT) has a very low predictive value. That means it is not a good predictor of who will conceive and who won't. I no longer recommend PCT to my patients. You are correct in mentioning the importance of using an LH stick to check when to perform the PCT. The most common cause of abnormal PCT is improper timing. But that is not the case in your situation.

If your PCT had been normal, you would have unexplained infertility and deserve a trial of ovulation induction and intrauterine insemination (IUI). I would do the same now. I rarely recommend antibody testing, as the treatment would still be the same whether or not a sperm antibody was present. So, I guess your physician is right on track. I believe it would be worth talking to your physician about the use of clomiphene and IUI.