Question 1

Question

A 27-year-old woman with Kallmann syndrome (congenital GnRH deficiency) desires pregnancy. She has been on estrogen-progesterone replacement for bone health. Her physician plans to switch her to pulsatile GnRH therapy. After 6 weeks of treatment, labs show: LH 4 mIU/mL, FSH 5 mIU/mL, estradiol 120 pg/mL. Ultrasound shows a 16mm dominant follicle. Evaluate and synthesize the physiologic response to determine the appropriate next intervention for ovulation induction.

Accepted Answer

Administer exogenous hCG to trigger ovulation and time intercourse

Answer

Continue current GnRH dosing and monitor for spontaneous LH surge

Answer

Add clomiphene citrate to augment endogenous gonadotropin release

Answer

Increase GnRH pulse frequency to stimulate endogenous LH surge

Answer

Switch to gonadotropin therapy with recombinant FSH and LH

Reproductive physiology (menstrual cycle, pregnancy) — MCQs

Reproductive physiology (menstrual cycle, pregnancy) — MCQs

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