Infertility: gonadotropin stimulation monitoring: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Infertility: gonadotropin stimulation monitoring

Sample item

A woman on gonadotropin ovulation induction for anovulatory infertility is found on ultrasound to have five follicles over 16 mm. What is the most appropriate step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Cancel the trigger and advise abstinence or barrier contraception to avoid high-order multiple pregnancy and OHSS

Gonadotropin therapy carries a risk of multiple pregnancy and OHSS, so follicular development is monitored by ultrasound. When more than about three follicles of 16 mm or more develop, the cycle is cancelled or converted to IVF, and conception is avoided. The trigger is withheld.

Option by option

  • A. Increase the gonadotropin dose

    Increasing the dose would worsen hyperstimulation.

  • B. Give hCG and encourage intercourse

    Triggering would risk high-order multiples.

  • C. Cancel the trigger and advise abstinence or barrier contraception to avoid high-order multiple pregnancy and OHSS (correct)

    Correct. Too many mature follicles require cancellation of the cycle.

  • D. Perform IUI as planned

    IUI would risk high-order multiples.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Cancel the trigger and advise abstinence or barrier contraception to avoid high-order multiple pregnancy and OHSS. Gonadotropin therapy carries a risk of multiple pregnancy and OHSS, so follicular development is monitored by ultrasound.

Why is "Increase the gonadotropin dose" not the answer?

Increasing the dose would worsen hyperstimulation.

Why is "Give hCG and encourage intercourse" not the answer?

Triggering would risk high-order multiples.

Why is "Perform IUI as planned" not the answer?

IUI would risk high-order multiples.

What concept does this question test?

It tests Infertility: gonadotropin stimulation monitoring in OBG. When more than about three follicles of 16 mm or more develop, the cycle is cancelled or converted to IVF, and conception is avoided. The trigger is withheld.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Infertility: gonadotropin stimulation monitoring?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.