The clomiphene citrate challenge test (CCCT) in women with elevated basal FSH: biological significance and predictive value.
OBJECTIVE
The rationale of the clomiphene citrate challenge test (CCCT) is that day 10 serum FSH is influenced by the quality of the recruited oocytes. Biological evidence supporting this assumption is, however, lacking. The aim of this study is to investigate the relationship between results from the CCCT and the quantity and the quality of the recruited oocytes.


METHODS
Patients selected for in vitro fertilization (IVF) and who were found to have elevated basal FSH (n=114) underwent an IVF cycle using follicles developing during CCCT. Subsequently, a subgroup of patients (n=89) underwent a second cycle receiving high doses of gonadotropins. The main outcome considered was the transfer of viable embryos.


RESULTS
During the CCCT cycle, the area under the receiver operating characteristics (ROC) curves for day 3 and day 10 serum FSH to predict embryo-transfer was 0.48 (95% CI, 0.37-0.60) and 0.74 (95% CI, 0.63-0.82), respectively. In the subsequent cycle, the area under the ROC curves for the two variables was 0.58 (0.43-0.72) and 0.58 (0.43-0.72), respectively.


CONCLUSIONS
CCCT effectively mirrors the quantity and the quality of the recruited oocytes but its predictive value is low.
Ragni
Guido
G
Infertility Unit, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy.
Chiaffarino
Francesca
F
Scarduelli
Claudia
C
Bonetti
Silvia
S
Nicolosi
Anna Elisa
AE
Arnoldi
Mariangela
M
Somigliana
Edgardo
E
D000328:Adult; D002996:Clomiphene; D010064:Embryo Implantation; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D005498:Follicular Phase / Q000097:blood; D006801:Humans; D009865:Oocytes / Q000502:physiology*; D010050:Ovarian Function Tests; D010062:Ovulation Induction; D012372:ROC Curve
D002996:Clomiphene; D005640:Follicle Stimulating Hormone