Evaluation of the significance of the estradiol response during the clomiphene citrate challenge test

Objective: To evaluate the relationship between the E₂ response during the clomiphene citrate (CC) challenge test and ovarian responsiveness to exogenous gonadotropins. Design: Performance of a CC challenge test followed by ovulation induction with exogenous gonadotropins as part of participation in an assisted reproduction program. Setting: Assisted reproduction program in a large military tertiary care center. Patients: Two hundred forty-seven women between the ages of 24 and 39 years with normal CC challenge tests within 1 year of their assisted reproduction cycle. Interventions: Performance of CC challenge tests and ovulation induction with exogenous gonadotropins as a component of an assisted reproduction cycle. Main Outcome Measures: Correlation of the E₂ response during the CC challenge test and peak E₂, the duration of stimulation, number of ampules of exogenous gonadotropins, number of mature follicles, number of mature oocytes recovered, and fertilization and pregnancy rates in an assisted reproduction program. Results: No correlation exists between the E₂ response during the CC challenge test and any of the parameters evaluated. Conclusion: Monitoring of the E₂ response during the CC challenge test did not predict ovarian responsiveness or pregnancy rates in patients participating in an assisted reproduction program and one may choose not to include it in routine testing.