EFFICACY OF SELECTION CRITERIA FOR OVARIAN RESERVE SCREENING USING THE CLOMIPHENE CITRATE CHALLENGE TEST IN A TERTIARY FERTILITY CENTER POPULATION

Objective: To examine selection criteria for ovarian reserve screening . Design: Retrospective study. Patients: Two hundred nineteen women un derwent testing for ovarian reserve for woman's age >35 years, any age with unexplained infertility, one ovary, or a poor response to hMG. I nterventions: Clomiphene citrate challenge test. Main Outcome Measures : Frequency of abnormal ovarian reserve screening, menstrual cycle par ameters, response to hMG, and pregnancy outcome by screening criteria. Results: One hundred eighty-four (84.0%) women had a normal ovarian r eserve screening test; 35 (16.0%) had an abnormal ovarian reserve scre ening test. Twenty-six had abnormal ovarian reserve screening when scr eened by age, 14 for unexplained infertility, 5 for poor response to h MG, and 6 for one ovary. Fifteen women with abnormal ovarian reserve s creening had more than one indication for screening. For women attempt ing pregnancy (n = 182), 49 of 148 (33.1%) with normal ovarian reserve screening became pregnant compared with 2 of 34 (5.9%) with abnormal ovarian reserve screening. Within each screening category, women with abnormal ovarian reserve had menstrual cycle parameters associated wit h a short follicular phase, required more hMG, and responded poorly to hMG. Conclusions: One of six women undergoing ovarian reserve screeni ng had an abnormal test, which was associated a poor reproductive outc ome. Age was the most important single criteria. Selected ovarian rese rve screening is simple and inexpensive and should be offered to all f ertility patients meeting the specific screening criteria listed above .