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Achieving and maintaining pregnancy after age 40
1Obstetrics and Gynecology, Thomas Jefferson University School of Medicine, Pennsylvania Hospital, Philadelphia, USA.
International Journal of Fertility and Women'S Medicine
|December 24, 1998
Summary
Testing ovarian reserve is crucial as women delay reproduction. The clomiphene citrate challenge test offers a simple, cost-effective method to predict fertility outcomes, aiding in reproductive planning.
Area of Science:
- Reproductive Endocrinology
- Infertility Diagnostics
Background:
- Increasing rates of delayed reproduction in the U.S. necessitate better assessment of ovarian reserve.
- A significant proportion of first births occur in women over 35, highlighting age-related fertility concerns.
Purpose of the Study:
- To evaluate the utility of the clomiphene citrate challenge test (CCCT) for assessing ovarian reserve.
- To determine the prognostic value of CCCT in predicting conception rates.
Main Methods:
- The study discusses the clomiphene citrate challenge test as a dynamic method for testing ovarian reserve.
- Compares CCCT to gonadotropic stimulatory tests, noting its simplicity and lower cost.
Main Results:
- Ovulation induction shows low delivery rates (2.4% at age 42) and no live births in women over 42.
- Abnormal CCCT results correlated with low conception rates (4.8% in one group).
- CCCT demonstrates a high negative predictive value (approximately 95%) for ovarian reserve.
Conclusions:
- The clomiphene citrate challenge test is a valuable prognostic tool for ovarian reserve.
- Wider adoption of CCCT can help manage patient expectations and reduce costs associated with fertility treatments like IVF.
- CCCT can guide decisions regarding fertility treatments, including oocyte donation.