In vitro fertilization (IVF) services for members over age 44 who meet medical necessity criteria. And, for members without premature ovarian insufficiency from age 40 to age 44 by the time of treatment a yearly clomiphene citrate challenge test (CCCT) is not required prior to the approval of IVF. A pre-service approval is required from Blue Cross and Blue Shield in order to receive these treatments. Refer to the rider for a complete description of covered services related to these fertility treatments.