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another question about my sis: clomid challenge test?

664 Views 3 Replies 3 Participants Last post by  BeeandOwlsMum
I posted a thread in this forum earlier this week about my sister who is TTC. She is 37 and has been TTC for less than six months--maybe four? or five? She was using TCOYF and got confused about her chart and so went to see an OB-GYN, who is in a total panic that my sister isn't ovulating, etc. etc. because of how her charts look. (She is using an OPK and temps only.)

Anyway this doc wants my sister to have a clomid challenge test. I went "Huh?" I looked it up using trusty Google and this is what I found:

What is a clomid challenge test (CCT)?

A clomid challenge test (CCT) is one way of measuring ovarian reserve. It is done by having blood drawn for an FSH level on Day 3 of your cycle (day 1 is the first day of your period). You then take Clomiphene Citrate 100 mg (two 50 mg tablets) on days 5 through 9 of your cycle. A repeat FSH level is drawn on Day 10.
What are normal results for a CCT?

Day 3 FSH level should be less than 12.
Day 10 FSH level should be less than 12.
Day 3 FSH level plus the Day 10 FSH level should be less than 25.
What does it mean if my test is not normal?

An abnormal CCT is associated with an increased risk of cycle cancellation and poor ovarian stimulation during IVF cycles. Pregnancy rates are lower in women with an abnormal Clomid challenge tests but some women are still able to conceive.
Have you ever had this test? Should my sister be having this test when she has been TTC for less than 6 months? Initially I said, "Your doctor sounds like an idiot, but it would be good to have these tests done so early so you will know if there is a problem." But are there risks associated with using clomid, even just the small amount in this test? Is it worth my sister's while to go through the stress of this when she isn't actually officially infertile?

Do you know if Toni Wachsler will look at people's charts for them? I am concerned that my sister is getting into a very medicalized and very stressful situation. I have read that stress can adversely affect ability to conceive. Your thoughts are so much appreciated!
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Well, I can't respond to all of your questions, but I can tell you a little about my own experience. I had been charting temps only since May 2003, which showed (using the TCOYF method) that I only ovulated about 3-4 times a year. In April '04 we had an ectopic pregnancy, and after that, I ended up at a reproductive endocrinologist (fertility doc). The first month (August 04) was the clomid challenge, as well as an hsg (ouch) and lots of other bloodwork. The clomid challenge is for measuring ovarian function, and is used esp. in woman with compromised ovarian function. There's a pretty good description of the side effects of clomid on the infertility thread that you can read.

That first month, I got very bloated on the clomid, plus I was very anxious b/c it was the only cycle to be paid for by my insurance. I was way emotional, feeling like it was our only chance. Needless to say, we didn't conceive. I decided then that I had to step away and learn more about my health and PCOS before continuing. So, I did that, and then in April I was ready. I have been taking clomid now for 3 months. The side effects have deepened - esp. visual "disturbances". We are hoping this month that we'll develop more than one follicle.

Anyway, 6 mo of trying without success is the standard for stepping in with women over 35. Just b/c she's having the testing done now doesn't mean that she can't make other choices afterward, but getting the info from that testing may be very important.

I hope this helps.
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Celesterra, thank you so much for responding! When my sister told me about this doctor visit initially, I thought she should go for the tests even though it was early, just because of her age. Then I heard "clomid challenge" and got a little freaked. I guess it's not the same as going on clomid for a long time. I like what you said about making other choices afterward.

I am sorry you (and others who have helped me here) have had to cope with all this stuff. It's really helpful to me and to my sister, with whom I'm going to share information, that you are willing to write about it.
Clomid challenge is exactly what it said.

One month of it to do this test will likely have low side effects. I guess the question is, why does the doc think she isn't ovulating? I used to be Fertility Friend guide, I can have a look at them if you would like. I am no Toni Weschler, but I can help a bit.

The tests can never hurt, and if something is wrong, it might be a simple fix.

It is a tough call, and a very personal call. So, that is the hardest part sometimes. Deciding what is right for you and how far you are willing to go with treatment. Remind you sister that she doesn't have to make a ll the decisions right now - but can change her mind and make new decisions as things progress.
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