Minimal investigation in Clomiphene cycle is the ruls-Why??

·         To what extent we should investigate prior to initiation of first cycle of CC ?:  :The  philosophy or say logic in the  minds of treating physicians are  as most of the women responds to 2-3 cycles of CC at the  dose of 100 mg of CC , so doctors becomes very hopeful and avoids detailed   investigations , By contrast in cases of  IUI , not to speak  of ART investigations are detailed. .-As large no of women ovulate with CC at the dosage of 50-100-150 mg of CC , most of us don’t estimate or evaluate thoroughly before initiating initial  few spells  of CC. This is more true if she is of average BMI and with no clinical evidence of hyperinsulinaemia, hyperandrogenaemia, galactorrhoea and her cycles are regular(eumenorrhoic) though most PCO women has H/O Oligomenorrhoea(delayed periods.

·          Most of us  hesitate to investigate thoroughly prior to initiate CC, more so when age of female partner is  less than 25 yrs of age .Because most of clinicians take it granted that if woman’s  androgen profile, glycemic profile, & PRL are normal as she is eumenorrhoic and many report pertaining to subtle changes of those hormones that is capable of adversely affecting  oogenesis may not be picked up by currently available  biochemical assays like  androgen profile , insulin assays & glycemic profiles.

·         Such minor changes are often difficult to pick by ordinary tests. How many members agree with this philosophy of minimal testing if female partner is aged 25 yrs and trying time is 2 yrs only. How many of us will insists on AMH, Day 3 AFC, Progesterone on day 3(basal) & on day 9 of cycle (premature Luteinization) , DHEASO4, HBA1C ?? Do members believe such expenses are worth doing and also consider that asking for too many tests will  add to the existing stress on the couple . What is your practice pattern.Pl share your views on this very important issue. How many of you believe this omission is a bad clinical practice?? .