Clomid Challenge Test (CCCT) – To Measure Your Ovarian Reserve

6 min read

Written by Sindhuja Prabhu

Sindhuja Prabhu

Clomid Challenge Test

In recent times, the age limit for women to have children has slowly and steadily increased. Over the last few years, society has accepted women choosing to have children at a later age and science has come a long way to support the same. There are several tests and treatments to help older women to have children. One such test is the Clomid Challenge Test

When a woman who is yet to have children or wants to have more, reaches 30 years of age or more, the biggest concern is her ovarian reserve. It is common knowledge that a woman’s fertility starts decreasing sharply when she nears 35 years of age. You can measure your ovarian reserve with a Clomiphene Citrate Challenge Test (CCCT).

In This Article

What is Clomid Challenge Test?

A Clomiphene Citrate Challenge Test also known as Clomid Challenge Test or CCCT is a blood test to determine a woman’s fertility. It helps to know more about the health of her eggs and ovaries. A CCCT enables fertility doctors to know how many eggs a woman’s ovaries contain.

A woman’s ovaries contain a limited number of eggs. Each egg is shed every menstrual cycle. Ovarian reserve is the quantity of eggs left in the ovaries. This reserve starts declining with age. In some cases, it could also decline due to genetics or other health reasons.

Based on Systematic Review done by Researchgate, CCCT can determine how many eggs you have left in your ovarian reserve. No tests can determine the exact number of eggs. All fertility tests including the CCCT can only estimate the ovarian reserve to an extent. If the result indicates your ovarian reserve is low and you are having trouble conceiving, you may opt for fertility treatments.

How Does Clomid Challenge Test Work?

How Does Clomid Challenge Test Work

Let’s first understand how this CCCT works exactly.

  • A woman’s body produces a hormone called the FSH (Follicle Stimulating Hormone). This hormone stimulates the growth of the eggs in the ovaries. An elevation in the FSH levels indicates the ovarian reserve is decreasing. The FSH level is at its highest just before the egg is released by the ovary.
  • In the Clomiphene Citrate Challenge Test, the FSH level is checked twice. First on day 3 of the menstrual cycle, next on day 10, after administering Clomid from day 5 to day 9 of your cycle.
  • Now, what this Clomid does inside is, fool the brain. It prevents the brain from sensing the estrogen. As a result, a limited amount of FSH is produced in addition to the usual levels. If a lot of FSH is produced, it indicates a diminished ovarian reserve, whereas a low FSH production indicates the ovarian reserve is good.
  • So, on day 10 when the second test is taken to measure the FSH levels, if the levels come back to normal, it means the woman’s ovarian reserve is good. If the FSH levels are high on day 10, it means she has a diminished ovarian reserve.

[Read : Normal Follicle Stimulating Hormone (FSH) Level to Get Pregnant]

When Should You Consider Taking CCCT?

If you are over the age of 35 or have been unsuccessful in your attempts of conceiving, you can check your ovarian reserve. Check with your fertility doctor first and discuss the need for and when to take the test. They can guide you as per your needs.

How is the Clomid Challenge Test Performed?

The Clomid Challenge Test is a blood test. The technician will draw your blood samples to carry out the test. The blood will be checked for FSH and estradiol levels. Some doctors may even order a transvaginal ultrasound to have a better picture of your ovarian reserve.

The Clomiphene challenge test is usually taken at two different times-once on the 5th day of the menstrual cycle and again on the 10th day.

You will be given 100mg of Clomid from day 5 to day 9 of your cycle, to check how much effect the Clomid has on your FSH levels when measured on day 10.

How Does Clomiphene Increase the Chance Of Pregnancy?

Clomiphene may cause your ovaries to release more than 2 eggs at a time. As a result, the chances of conceiving twins increase.

Clomiphene also makes your body produce more FSH hormones. An increase in FSH levels improves your chances of growing an ovarian follicle, which can then trigger ovulation. Ovulation is when the egg is released and the prime time for fertilization.

What Are Considered Normal Results For CCCT?

How is Clomid Challenge Test Performed

For any blood test you take, the results will vary from clinic to clinic. This is why each of these clinics mentions the referral range next to each finding. So, once you get back your CCCT results, you need to check with your doctor instead of jumping to conclusions about your fertility or future possibilities of conceiving.

If your FSH levels are below 10IU/L, it is considered to be within the normal range. The range applies to both day 3 and day 10 after taking Clomid for about 5 days. If the FSH levels are above 10 IU/ L, it indicates a possibility of diminished reserves in your ovaries.

What Does Poor CCCT Mean?

When the CCCT results are poor, without the age factor, it could mean:

  • Fewer eggs were retrieved
  • Higher chances for a miscarriage
  • Higher risk for a chromosomally abnormal embryo
  • Lower success rate with IUI or IVF treatments
  • Lower response to injectable drugs for assisted productive technology cycles.

What Happens After a Clomid Challenge Test Failure?

Though the CCCT can help you understand more about your ovarian reserve it cannot determine the quality of the eggs left in the ovaries. Many fertility clinics do not take a chance when the CCCT tests are not favorable.

They would suggest you go in for fertility treatment with donor eggs. The reason is, they are not sure about the quality of the eggs or how healthy the forming embryo will be. Since the risk of a miscarriage is high when your CCCT test results are low, they will try to avoid the risk.

[Read : Getting Pregnant After Miscarriage]

When to Consult the Doctor?

When to Consult Doctor

Age affects fertility in both men and women. If one or both partners are above the age of 35 or if you have been trying to conceive for over a year, you should consult a fertility specialist.

Many couples face different fertility issues. While some need just a little assistance, some may need fertility treatment. It is advisable to consult a well-qualified specialist if you are having trouble conceiving.

Just because your Clomid Challenge test results are low, does not mean you cannot conceive naturally. Similarly, if your CCCT test results are high, there is no guarantee that you can conceive naturally and easily. Many women with high ovarian reserve need assistance to conceive and many women with low reserve or at a higher age, conceive naturally without any assistance.

[Read : Why I Delayed My Pregnancy To 30]


1. How Long After Taking Clomiphene Will I Ovulate?

You can expect to start ovulating about 5 to 10 days after your last dosage of Clomid. So, for example, if you have taken clomid medications between day 3 and day 7 of your cycle, ovulation can occur at any time between days 10 and days 16 of the cycle.

2. How Many Eggs Are Released When Taking Clomid?

Clomid can make your ovaries release about 2 or 3 eggs at a time. Do remember that this medication’s effects will last only during the cycle that you take it.  In cycles that you don’t take this medication, you will release only one egg.

3. What is the Success Rate For Clomiphene For Pregnancy?

If your menstrual cycle is regular and you are not too old, there is a 30% – 40% chance for the intake of Clomiphene to result in a pregnancy.

4. Does Clomiphene Increase the Risk of Twins?

Yes. Clomiphene can result in twin pregnancy 5% – 12% of the time. This is because the drug results in the releasing of two or three eggs during the cycle. If more than one eggs get fertilized, you can expect twin or multiple gestations.

Read Also: Using Donor Eggs – The Conception Alternative You Need to Know About

Sindhuja Prabhu,M.Sc (Psychology),PGDBM

Sindhuja, a mother of two, is an obsessive mom with a keen interest in psychology, especially child psychology. Her quest for knowledge and way with words led her to become a passionate content writer. She transformed her love for writing into a full-fledged career which incidentally also turned up being the perfect stress buster for the last 5 years.Read more.

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