Clomid Challenge Test

Our IVF specialist had recommended that I take what is called a Clomid Challenge Test. After our second failed IVF, I had asked him if there was any way to know for certain that I would not be able to conceive using my own eggs. He said I should do the Clomid Challenge and I will know for certain if I have an ovarian failure. I decided that I would wait a couple of months for my body to completely get back to its normal state after being on fertility drugs. I decided to do it this cycle. Two days ago (which is my day 3 of my cycle) I went and got my blood drawn for FSH level. Today, I began taking clomid (100mg) and I will for four more days. Then, I go in again to get my blood drawn to test for my FSH level. Basically, when I add the two FSH levels and the sum is 20 or greater it means I have an ovarian failure. At this point, doctors usually do not do IVF for their patients but advise them to go directly to egg donation. Hopefully, this test result will provide the information that I need. For those of you who want to know more about the clomid challenge, you can read further below. I found this information on a website.

The clomiphene citrate (Clomid) challenge test (CCCT) is a sensitive means to measure ovarian reserve and is often conducted if the FSH level is 10-15 mIU/mL or the E2 is >65 pg/mL The Clomid Challenge Test is routinely performed at our clinic in women aged 38 years or older regardless of how the cycle day 3 levels look. This will identify patients with incipient ovarian dysfunction.

The Clomid challenge test should also be considered in women of any age with otherwise unexplained infertility as approximately 30% will show abnormalities that adversely impact their prognosis with fertility treatment.

Ovarian reserve, along with female patient age, is an important predictor of treatment success. The Clomid Challenge Test is Conducted as Follows:
Patients call the office on Day 1 of the menstrual flow (not spotting). If this is on the weekend, please call Monday morning.

Patients will come into the office to have blood drawn for an E2 (Estradiol) level and FSH (Follicle Stimulating Hormone level) on Day 2, 3 or 4 of the menses (period).

Patients begin Clomid -100 mg per day on Day 5 of menses. This will be two tablets, 50mg each, which are taken together at the same time each day.

Tablets are taken on cycle Days 5-9, and patients return to the office on cycle Day 10 or 11 (after 5 days of Clomid). The FSH level will be repeated on Day 10 or 11.

A level from 10-12.5 mIU/mL predicts resistance to fertility medications and a diminished prognosis. At 12.5-15 mIU/mL, the prognosis is poor but pregnancies do occur with aggressive treatment. Levels greater than 15 mIU/mL indicate that infertility treatment with the patient’s own eggs is not likely to succeed and that egg donation should be offered. Patients with any FSH level greater than 10 mIU/mL should be referred to a fertility specialist for further evaluation.

A poor Clomid challenge test indicates that it is unlikely that the couple will be successful using in vitro fertilization, IVF. Some clinics do not offer IVF to couples failing the CCCT test and others offer it but clearly explain the poor chance of success. Donor egg IVF is the best option for these couples.