فعلا معلومه جديده وهو من الفحوصات النادرة الطلب ’ ولكنه مطلوب بشده فى مراكز الخصوبه وعلاجها فى المملكه المتحده , مشكور اخى ع الايضاح وفقك الله لما تحب وترضى

وجزاك خيرًا مثله أخي الكريم


جزاك الله خيرًا و شَكرَ لك
والدعاء لكم مستمر، إذ إن حالنا تجاهكم يُسوِّد الوجه، ولن نجد ما نجيب به ربنا عندما يسألنا عن إخواننا كيف لم ننصرهم!
فلعل الدعاء يخفف ذنب من لا يستطيع حيلة و لا يهتدي سبيلاً.
في حفظ الله ورعايته

أهلاً بك أخي الكريم
فعلاً يستحق الشكر كل من قدم إجابة في هذا الموضوع.
حياك الله.

UTMB POINT OF CARE TESTING PROCEDURES
POLICY -
Policy
Page 1 of 7
Postcoital (Sims-Huhner) Test
PPMP- PROVIDER PERFORMED MICROSCOPY PROCEDURES
Effective: 10/99
Reviewed: 02/09
Page 1 of 7
Postcoital (Sims-Huhner) Test
Purpose The purpose of this document is to provide instruction to the evaluation of
post-coital cervical mucus according to the Sims-Huhner technique.
Audience The information in this document is applicable to all physicians trained in
infertility who are responsible for delivering quality patient care.
Policy All point-of-care testing performed at UTMB, whether referred to the central
laboratory or done at the patient’s bedside requires a documented physician
order prior to collection of the specimen. CLIA 88 guidelines require all
participating testing sites hold a PPMP (Provider Performed Microscopy
Procedures) license aside from the central Laboratory’s CLIA license.
This requirement is restricted to microscopy procedures (PPM’s) and does
not apply to other moderate-complex procedures performed at the provider’s
site.
Test Principle
When investigating infertility circumstances, consistency of cervical mucus
as well as the ability of spermatozooa to penetrate the mucus and maintain
activity are two useful indicators. Cervical mucus is collected 2 to 8 hours
after coitus and evaluated. Specimen pH and ferning are determined;
tenacity of the mucus (spinnbarkeit) is determined by measuring the
maximum distance a string of mucus can be drawn before breakage. A drop
of mucus is placed on a glass slide, cover-slipped and examined
microscopically for the presence of motile sperm. Other significant
elements are accounted for such as leukocytes, erythrocytes and
trichomonads.
Patient
Preparation
Couple is told to abstain from intercourse for 48 hours and then to have
coitus two to eight hours prior to scheduled appointment.
Stress that couples should refrain from using spermicidal gels, lubricants or
douches.
Specimen • Cervical mucus collected 2 to 8 hours after coitus.
Supplies
• Vaginal speculum
• Gloves
• Small cotton swabs
• Tuberculin syringe without needle
• Microscope slides and coverslips
• pH paper
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POLICY -
Policy
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Postcoital (Sims-Huhner) Test
PPMP- PROVIDER PERFORMED MICROSCOPY PROCEDURES
Effective: 10/99
Reviewed: 02/09
Postcoital (Sims-Huhner) Test
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Reagents No reagents are required for this procedure.
Specimen
Collection
General safety and universal precautions must be followed when handling
body fluids.
Step Action
1. Position patient in the usual fashion for a pelvic examination.
Label 3 slides with the following: ‘Fern’, ‘Endocervix’, and
‘Exocervix’.
2. Insert speculum into vagina and wipe external os clear of mucus
with small cotton swab and spread mucus onto slide labeled fern.
Allow to dry.
3. Obtain samples from endocervix and exocervix by aspirating from
endocervix and withdrawing syringe.
4. Place first part of specimen onto glass slide labeled exocervix and
cover with coverslip.
5 Place remaining portion from inside syringe onto slide labeled
endocervix and cover with coverslip.
6 Aspirate fluid from vaginal pool and apply to slide labeled vagina
and cover with coverslip.
Examination
Procedure
Specimen must be examined as soon as possible to ensure maximum accuracy of
results.
Step
Action
1. Record amount, clarity, and viscosity of mucus cervical.
2. Observe specimen microscopically for the presence of sperm and
percentage of motile forms. Estimate and record number per highpower
field.
3. Observe sperm for directional kinetics and clumping.
4. Report any leukocytes, erythrocytes, trichomonas, yeast or clue cells
present.
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POLICY -
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Postcoital (Sims-Huhner) Test
PPMP- PROVIDER PERFORMED MICROSCOPY PROCEDURES
Effective: 10/99
Reviewed: 02/09
Postcoital (Sims-Huhner) Test
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Examination
(continued)
5. Measure and record specimen’s tenacity (spinnbarkeit) by raising
cover-slip and measuring the distance mucus can be drawn
without breaking.
6. Record pH of each wet prep.
7. Determine whether ferning is present.
Interpretation
of Results
and
Normal
Values
• Appearance: At midcycle, the mucus should be clear and watery.
• Spinnbarkeit (tenacity): 8 to 10 cm.
• Presence and Motility of Spermatozoa: Within 2 to 8 hours after
coitus, at least 20 motile sperm per HPF.
• Ferning is present.
• The pH in endocervix should be above 7.
Expected
Results
• Cervical mucus undergoes quantitative and qualitative changes
throughout the menstrual cycle.
• The postcoital test shows better quality of mucus and sperm penetration
at the ovulatory phase as compared to other phases.
• Progesterone during the secretory phase causes an increased viscosity.
• During the ovulatory phase, the amount of mucus is maximal while
viscosity is decreased facilitating penetration by spermatozoa.
Interfering
Substances
The use of contraceptive and spermicidal gels, lubricants or douches will
interfere with this procedure.
Limitations
of the
Procedure
• This procedure is not intended to detect the presence of sperm from
garments or specimens from alleged rape victims. Other screening
procedures are available for this type of medicolegal cases. Refer to
Technical Information section for a brief description of such procedures.
• This procedure does not distinguish between the different causes
attributed to infertility.
UTMB POINT OF CARE TESTING PROCEDURES
POLICY -
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Postcoital (Sims-Huhner) Test
PPMP- PROVIDER PERFORMED MICROSCOPY PROCEDURES
Effective: 10/99
Reviewed: 02/09
Postcoital (Sims-Huhner) Test
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Technical
Information
• It is important the patient be in the ovulatory phase as determined by
basal temperature records.
• Any delay in the examination of mucus after collection affects the
motility of the sperm and may not give a true indication of the existing
conditions.
• Screening tests for qualitative determination of semen are briefly
described below:
• Acid phosphatase Determination (ACP): Based on the detection of such
enzyme in vaginal lavage/aspirates or on wash fluids from suspected
semen stains. Most common and practical method available includes a
colorimetric spot test based on the enzyme’s utilization of phosphatebased
substrates. Pro’s: results are independent of sperm count. Con’s:
marker degrades overtime to non-detectable levels. Other methods
available include immunodiffusion, paper chromatography, and
radioimmunoassay.
• Zinc Test: Takes advantage of the unusually high concentrations of zinc
in semen ( 140 g/mL vs. 1.2 g/mL in plasma). Treatment of specimen in
question with 1-(2- pyridylazo)-2-naphthol (commonly refferred to as
PAN) leads to the formation of an insoluble complex between PAN and
zinc. Positive reactions are depicted by a color change from yellow to
rose-red.
• Modified Zinc Test: Rapid and colorimetric also. Consists of paper strips
impregnated with modified PAN (with added Triton X in TRIS buffer).
Technique was developed by Hoover and van de Voorde in 1992 and
proved to be more sensitive and specific when compared to the classic
spot acid phosphatase. Pro’s: Results can be obtained within 1 minute,
strips are stable for 3 months when properly stored. Like with the ACP
spot test results are not affected by low sperm counts.
• Florence Test: Screens for choline in seminal fluid upon addition of an
iodine-based reagent to specimen extract. Evidence of semen is
demonstrated by the presence of rhombic or needle-like crystals of
periodide of choline.
• Lactate Dehydrogenase isoenzyme: differentiates between semen and
UTMB POINT OF CARE TESTING PROCEDURES
POLICY -
Policy
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Postcoital (Sims-Huhner) Test
PPMP- PROVIDER PERFORMED MICROSCOPY PROCEDURES
Effective: 10/99
Reviewed: 02/09
Postcoital (Sims-Huhner) Test
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other body fluids. It also distinguishes between human and non-human
semen.
Microscope
Preventative
Maintenance
Proper care and preventative maintenance should be performed and
documented daily or after use in order to ensure optimum performance. In
addition, a thorough annual cleaning by a technical representative is
recommended. Microscope Maintenance log.
The following conditions apply:
1. Microscope should be kept covered when not in use.
2. Keep surfaces free from dust.
3. Clean objective lenses, eyepieces and condenser daily, or after use.
A. Use a high quality lens paper that has been dampened with an
approved lens cleaner. Do not use Xylene or other chemicals
1) Dry lens paper can scratch the lenses.
2) DO NOT USE Kimwipes ®, commercial tissue, or
gauze.
B. The 10X and 45X objectives must be kept oil-free at all times.
Oil can impose permanent damage to the objective.
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POLICY -
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Postcoital (Sims-Huhner) Test
PPMP- PROVIDER PERFORMED MICROSCOPY PROCEDURES
Effective: 10/99
Reviewed: 02/09
Postcoital (Sims-Huhner) Test
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Proficiency
Testing
For quality assurance purposes, sites will be subject to proficiency testing semiannually.
• Select sites will be randomly chosen and notified.
• Proficiency tests will consist of case study scenarios and a
corresponding digital image.
• PPMP online tests maybe accessed through the POC Website @
http://www.utmb.edu/poc shortly after sites receive notification.
Step Action
1. For full and proper credit, examinees are required to fill in the
required fields as spelled in the test instructions.
2. Passing score = 100 percent
3. Upon test completion, examinees receive their scores. Results are
automatically saved onto a database.
References
AABB Technical Manual. 12th Ed. 1996.
COLA Guide to Simple Laboratory Testing. February 1998.
Henry, J.B. Clinical Diagnosis and Management by Laboratory Methods.
17th Ed., Philadelphia, PA: W.B. Saunders, 1984.
Hooft, P.J., Voorde, H.P. Bayesian evaluation of the modified zinc test and
the acid phosphatase test fofr forensic semen investigation. American
Journal of Forensic Medicine & Pathology. 18(1):45-9, March 1997.
Hooft, P.J., Voorde, H.P. A more sensitive modification of the zinc test for
seminal traces suitable for stable test paper strips. Forensic Science
International 53:131-3. 1992.
Rapid Spot tests for identifying suspected semen specimens. Forensic
Science International 72:191-7. 1995
Laboratory Survival Guide
UTMB POINT OF CARE TESTING PROCEDURES
POLICY -
Policy
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Postcoital (Sims-Huhner) Test
PPMP- PROVIDER PERFORMED MICROSCOPY PROCEDURES
Effective: 10/99
Reviewed: 02/09
Postcoital (Sims-Huhner) Test
Page 7 of 7
Policy Revision Detail
Date Page Revision Signature
2/4/09 7 Added Policy Revision Detail Table

http://www.utmb.edu/POC/SOP/2009/SOP...al%2002-09.pdf

اضغط على هذا الرابط وادعيلى

http://www.utmb.edu/POC/SOP/2009/SOP...al%2002-09.pdf

السلام عليكم اشكرك دكتورنا العزيز MSC lab
على هذة المعلومات القيمه الغنيه اود ان اضيف باختصار شديد عناصر التقرير ارجو ان تكون ذات قيمه:
Vaginal smear: if there were sperms motile or even not moving
Cervical smear : if there sperms
Microscopic examination for both smears : pus cells , RBCs , Parasites (Tricomonas vaginalis) if present & fungus cells (Candida albicans) if present.

جزاكَ الله خيرًا، وأثابك، وأحسنَ خاتمتك.
قد احتفظتُ بالملف، شكرَ الله لك.

جزاكَ الله خيرًا، وشكرًا لك ولكل من أضاف أية معلومة.
يكفي أن مشاركاتكم بعثت في هذا الموضوع الروح، بعد أن بقي سؤالًا بلا جوابٍ مدة طويلة.
في حفظ الله ورعايته.

يعطيك العافية يارب

report of post-coital test

شكرااااا جزيلا على المعلومات المفيده