Inhibin-B: the physiologic basis of the clomiphene citrate challenge test for ovarian reserve screening

Fertil Steril. 1998 Mar;69(3):474-7. doi: 10.1016/s0015-0282(97)00531-1.


Objective: To determine inhibin-B concentrations during ovarian reserve screening in women with normal and diminished ovarian reserve as determined by the clomiphene citrate challenge test.

Design: Retrospective.

Setting: Tertiary fertility center.

Patient(s): Women undergoing ovarian reserve screening for a routine fertility evaluation.

Intervention(s): Clomiphene citrate challenge test.

Main outcome measure(s): Inhibin-B concentrations on menstrual days 3 and 10.

Result(s): Nineteen patients with normal ovarian reserve and 15 with diminished ovarian reserve had serum inhibin-B concentrations determined during ovarian reserve screening. For all patients, day 10 inhibin-B concentrations were higher than day 3. Women with normal ovarian reserve had higher inhibin-B concentrations on both days 3 and 10 than women with diminished ovarian reserve. Inhibin-B concentrations demonstrated a negative correlation with FSH levels on both cycle days 3 and 10 and a positive correlation with E2 on cycle day 10.

Conclusion(s): Women with diminished ovarian reserve during ovarian reserve screening had reduced granulosa cell inhibin-B production compared with women with normal ovarian reserve. The lower inhibin-B concentrations may be responsible for the elevated FSH concentrations and may be indicative of the aging follicular apparatus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Clomiphene*
  • Female
  • Follicle Stimulating Hormone / blood
  • Granulosa Cells / metabolism
  • Humans
  • Infertility, Female / diagnosis*
  • Infertility, Female / physiopathology
  • Inhibins / biosynthesis
  • Inhibins / blood*
  • Kinetics
  • Ovary / physiopathology*
  • Retrospective Studies


  • Clomiphene
  • Inhibins
  • Follicle Stimulating Hormone