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

The Clomid challenge test should also be considered in women of any age with otherwise unexplained infertility as approximately 30 percent 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 Follo

1. Fertility patients must sign the Clomid Consent Form, which lists the possible side effects, before starting the medication.
2. Patients call the HRC office on Day 1 of the menstrual flow (not spotting), or on Monday morning if this is on the weekend.
3. 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).
4. 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.
5. 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.

Patients are notified of test results by their coordinator or physician:

• 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 have 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.