Take the Clomid Challenge

"Do I have to study?" I wondered, “If I take the CCCT (Clomiphene Citrate Challenge Test) do I win a medal? Can I get a happy face on my term paper?” Well...sort of. It was simple...kind of...well you see there was this snowstorm. I'm getting ahead of myself. Let's start with the geeky part.

In Dec. 2008, the RE's office asked me to come in on day 3 of my cycle for a baseline ultrasound and to give blood for the hormone evaluation. Here is a good article that includes a description on the baseline ultrasound from www.bellybelly.com.au and some more info on infertility preliminary tests.

As I understand it, the Day-3 blood, along with the Day 10 post-clomid blood test assesses the levels of hormones of FH, LH and Estradol. The combination of the blood test results and the baseline ultrasound which includes checking the ovaries, uterus and an antral follicle count are used to estimate ovarian reserve and egg quality. This test made me particularly nervous. I was 39 when I gave blood for the test in early December, but I was going to turn 40 very very soon. If you look at fertility rates in patients who have poor numbers for this CCCT test, the chances that they will get pregnant using their own eggs is significantly reduced per cycle. Sometimes going from a 70 to 30 percent probability. That’s a huge drop. I have read some infertility blogs where women are concerned about their egg quality, fail several IVF cycles, but never mention anything about this test in their writings. I am always curious if their doctor’s office performed this test and whether they had a good or poor result.

Here is the best description I found on the net for the purpose of the Clomid Challenge test:

Clomid Challenge Test
The Clomid challenge test is another way to predict ovarian reserve. A poor result is an indication that advanced reproductive technologies, using the patient's eggs, will not be successful. Estradiol, FSH, and LH are measured on day three of the menstrual cycle. Clomid is administered on day's five through nine; the FSH level is measured again on day ten. An elevated level on day ten is considered abnormal. Most patients who have an abnormal Clomid Challenge test are advised to use donor eggs or seek adoption.

So I gave my blood and had by ultrasound, then I took the clomid pills on days 5-9 and was ready go go on for my day 10 blood draw, but there was this huge snowstorm that had been going on for days and they couldn’t get anyone into the office on a Sunday for the blood draw. The RE’s office was very nice and promised, since we had to do the test again next month, that they wouldn’t charge me for the cost of the test at all (not even for the next month’s test).

My RE’s office lists their success rates and I believe these are the ones report to the CDC, but they also break down the success rates into further categories of “Good Prognosis”, “Medium Prognosis” and “Poor Prognosis.” I am very lucky. My CCCT test results showed my ovarian reserve is fine and that I “passed” the test with good results. In the words of DocO “you have the best numbers possible for a women of your age. BUT…this doesn’t mean there is any time to delay. We are still talking about 40 year old eggs.” Yeah, I know but this sure helps a lot toward my goal of staying optimistic.