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. “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.
A CCCT may be helpful to determine ovarian reserve, that is, how many remaining, viable eggs a woman has stored in her ovaries. The test analyzes the level of follicle-stimulating hormone (FSH) in a woman’s blood on both the 3rd and 10th days of her period. During this time, she takes clomiphene citrate each day.
Sample test procedure:
- Day 1: Begin menstrual cycle
- Day 3: Blood draw for Serum Estradiol (E2) and Serum FSH levels
- Day 5-9: Clomid 100mg DAILY (two 50 mg tablets)
- Day 10: Blood draw to observe change in levels
Women with elevated FSH levels may demonstrate diminished ovarian reserve. That information can provide guidance for treatment. If FSH levels are up to 15, women still may conceive, although not always with their own eggs.
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 cases 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, according to Jeffrey Deaton, MD, of Premier Fertility Clinic, Greensboro, NC.
RMANJ.com: Clomiphene Citrate Challenge Test IVF.com: Clomiphene Citrate Challenge Test CaliforniaIVF.com: Clomiphene Citrate Challenge Test OxfordJournals.org: Clomiphene Citrate Challenge Test