Clomiphene Citrate Challenge Test

How many eggs does a woman typically have? 

Women are born with their lifetime supply of eggs within the ovaries.  Each month follicles, each of which contains one egg, are recruited under the influence of follicle stimulating hormone. One follicle will become dominant, develop to maturity, and be ovulated.

What is ovarian reserve?

Ovarian reserve is a measure of the “quality” of the eggs remaining within the ovaries. Ovarian reserve naturally declines as a woman ages and approaches the menopause. However, diminished reserve can occur in younger women due to perimenopause, genetics, or for unknown reasons.

How is ovarian reserve measured? 

In the standard infertility evaluation, levels of the hormones FSH, LH, and etradiol are measured on day three. An elevated FSH level on day three is one indication of poor ovarian reserve or that the menopause is approaching.

What is the clomiphene citrate challenge test? 

The clomiphene citrate challenge test (CCCT) provides an additional assessment of ovarian reserve. It is performed by measuring the day three FSH and estradiol levels, the patient takes 100 mg of Clomid on cycle days five to nine, and her FSH is measured again on day 10.  The test is abnormal if either the day three or day 10 FSH values are elevated or if the day three estradiol is greater than 80 pg/ml.

What are a patient’s options if a CCCT test indicates poor results? 

A poor CCCT test, regardless of patient age, indicates that there will be a decreased response to injectable FSH in assisted reproductive technology cycles. Pregnancy success rates are very low in these women and there is an increased chance of miscarriage.

Many infertility treatment centers do not offer IVF to women who have a poor clomiphene citrate challenge test result.  IVF using donor eggs or adoption are usually the best options for these couples.

 

 

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Last Updated: 10-21-2014
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