Clomiphene Citrate Challenge Test

There are a variety of diagnostic tests for infertility. One that you might have heard of is the clomiphene citrate challenge test (CCCT), also referred to as the Clomid challenge test. It is a method of assessing the age-related decline in fertility or “decreased ovarian reserve.” As women age, so do the eggs in their ovaries, which over time leads to lower pregnancy rates and higher miscarriage rates. It is difficult to accurately predict the age-related decline in fertility for an individual patient without doing hormonal testing. The most comprehensive test for assessment of ovarian reserve is the CCCT.

The CCCT is usually recommended for patients 38 years of age or older, those with unexplained infertility, those with a prior history of ovarian surgery, those with poor responses to fertility medications, and those where other symptoms may be suggestive of decreased ovarian reserve (such as shorter menstrual cycles).

The test is performed as follows:

• On menstrual cycle Day 2 or 3 (second or third day of flow), have a blood test for FSH and Estradiol

• Take Clomiphene Citrate, 2 pills per day (100 mg total dose) from cycle Days 5-9

• On cycle Day 10, have a blood test for FSH

Your physician will interpret the tests results and provide you with an assessment.

The most common side effect of clomiphene citrate is flushing; these symptoms usually end by day 11. Other side effects include headache, breast tenderness, nausea, and vaginal dryness. Clomiphene should be discontinued if visual side effects are present (e.g. Blurry vision).

You can try to conceive during your CCCT month. There is an increase in the chance of twins to 5 – 10% chance, but multiple births greater than twins are rare.

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