Fertility Challenge
While Clomid can help induce ovulation, the use of this medication can also help a physician to determine the state of a woman's ovarian reserves by giving some idea of her hormone levels. The term "ovarian reserves" is used to describe a woman's likelihood of conceiving a child. A woman found to have decreased ovarian reserves has fewer chances of becoming pregnant.
Ovarian Reserves
When Clomid is used to assess a woman's ovarian reserves, this is called the Clomid challenge test. But the test has other names, too: Clomid challenge, clomiphene citrate challenge, clomiphene challenge test, or even CCCT.
The main issue with the Clomid challenge is to see what happens to the FSH hormones or follicle stimulating hormones. These are the hormones that stimulate the woman's ovaries so that egg follicles will be developed. Clomid causes a small rise in a woman's levels of FSH. This increase in FSH is desirable and it is hoped that as a result of these rising levels, a woman might conceive.
Suppressing Hormones
At the same time, however, when FSH production is rising, the ovaries begin to manufacture suppressing hormones. This in turn, causes the FSH levels to drop. After ten days on Clomid, it is usual for the FSH levels to have dropped back down to within the normal range thanks to the effects of these suppressing hormones. But, if the FSH levels are still high on the 10th day of Clomid treatment, this signifies an abnormal finding and indicates that a woman's ovarian reserves are poor.
An illustrative example may be helpful here. Let's imagine that a physician gives the Clomid challenge test to a 24 year old woman. The test yields an abnormal result. This is taken to mean that the woman hasn't many eggs left in her ovaries. This is a reasonable assumption since a 24 year old woman should have many eggs remaining.
But a woman who is postmenopausal would be expected to have high FSH levels after the 10th day into the Clomid challenge because we know that she is past the point of being fertile. It is usual for a woman's store of eggs to be depleted as time elapses and this can be attributed to a gradual, yet constant state of egg degeneration. However, in some cases, this process of degeneration has been sped up for reasons unknown.
The main reason for performing the Clomid challenge test is to provide information to your physician about your store of eggs. Is your fertility problem due to the depletion of your store of eggs, or is the problem more about the degeneration of the eggs happening much faster than it should? Pinpointing the answer to this question will help your doctor craft a course of fertility treatment that can give you the best possible chances for conception.
In addition to aging or a faster rate of degeneration, other factors that cause the egg stores' depletion includes smoking—a known factor for generating an abnormal result on a Clomid challenge test—and ovarian surgery that may have had an negative impact on her store of eggs.
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