title: The clomiphene citrate challenge test (CCCT) in women with elevated basal FSH: biological significance and predictive value.
abstract: 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.
authors.affiliation: Infertility Unit, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Ragni
authors.forename: Francesca
authors.initials: F
authors.lastname: Chiaffarino
authors.forename: Claudia
authors.initials: C
authors.lastname: Scarduelli
authors.forename: Silvia
authors.initials: S
authors.lastname: Bonetti
authors.forename: Anna Elisa
authors.initials: AE
authors.lastname: Nicolosi
authors.forename: Mariangela
authors.initials: M
authors.lastname: Arnoldi
authors.forename: Edgardo
authors.initials: E
authors.lastname: Somigliana
mesh_terms: 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
chemical_list: D002996:Clomiphene; D005640:Follicle Stimulating Hormone