Document Detail


The clomiphene citrate challenge test for the prediction of poor ovarian response and nonpregnancy in patients undergoing in vitro fertilization: a systematic review.
MedLine Citation:
PMID:  16962116     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To systematically review the value of the clomiphene citrate challenge test (CCCT) in the prediction of poor ovarian response and pregnancy in IVF. DESIGN: Systematic review. SETTING: All studies that evaluated the CCCT in the prediction of poor ovarian response or pregnancy after IVF. PATIENT(S): Infertility population undergoing an IVF treatment. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Poor ovarian response, nonpregnancy. RESULT(S): From the literature we identified and analyzed 12 studies on the CCCT according to preset criteria. In predicting poor response, the sensitivity and specificity of the CCCT varied from 35% to 93% and 47% to 98%, respectively. In predicting nonpregnancy, the sensitivity and specificity varied from 13% to 66% and 73% to 97%, respectively. Because of heterogeneity among studies, a summary receiver operating characteristics (ROC) curve could not be estimated. Back-to-back comparison of the CCCT with basal FSH was possible in six studies. In predicting poor response, the sensitivity of the CCCT increased to some extent, whereas specificity did not increase or even diminished. In predicting nonpregnancy, the CCCT also showed an increase in sensitivity, counteracted by a decrease in specificity. CONCLUSION(S): Summary estimates of test accuracy for the CCCT in IVF are not possible, because of heterogeneity among individual studies. A subanalysis of studies comparing basal FSH and the full CCCT showed that the CCCT has hardly any additional value.
Authors:
Dave J Hendriks; Ben-Willem J Mol; Laszlo F J M M Bancsi; Egbert R te Velde; Frank J M Broekmans
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review     Date:  2006-09-07
Journal Detail:
Title:  Fertility and sterility     Volume:  86     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-10-09     Completed Date:  2006-11-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  807-18     Citation Subset:  IM    
Affiliation:
Department of Reproductive Medicine, Division of Obstetrics, Neonatology and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands. hendriks.kuipers@casema.nl
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MeSH Terms
Descriptor/Qualifier:
Adult
Clomiphene / diagnostic use*
Female
Fertility Agents, Female / diagnostic use
Fertilization in Vitro / statistics & numerical data*
Humans
Infertility, Female / diagnosis*,  epidemiology,  therapy*
Outcome Assessment (Health Care) / methods*
Ovarian Function Tests / methods*
Ovary / drug effects
Ovulation Induction / methods,  statistics & numerical data
Pregnancy
Pregnancy Outcome / epidemiology*
Prognosis
Reproducibility of Results
Risk Assessment / methods
Risk Factors
Sensitivity and Specificity
Treatment Outcome
Chemical
Reg. No./Substance:
0/Fertility Agents, Female; 911-45-5/Clomiphene

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