Infertility: unexplained infertility: 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: unexplained infertility

Sample item

A 31-year-old couple has had 2 years of infertility with normal semen, patent tubes on HSG, and confirmed ovulation. What is the usual stepwise treatment?

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

The answer and the reasoning

C. Mild ovarian stimulation with IUI for several cycles, then IVF if unsuccessful

Unexplained infertility is a diagnosis of exclusion, and expectant management is reasonable for younger couples with a good prognosis. Stimulated IUI for three to six cycles is the first active treatment, and IVF is offered after failure or earlier if the woman is older or the duration is long. Laparoscopy may be considered to exclude endometriosis.

Option by option

  • A. Immediate laparotomy and tubal surgery

    There is no tubal disease to repair.

  • B. Hysterectomy

    Hysterectomy is not a treatment for infertility.

  • C. Mild ovarian stimulation with IUI for several cycles, then IVF if unsuccessful (correct)

    Correct. Stimulated IUI followed by IVF is the usual progression.

  • D. Long-term clomiphene alone for 3 years

    Prolonged clomiphene beyond about 6 to 12 cycles is not recommended.

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.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Mild ovarian stimulation with IUI for several cycles, then IVF if unsuccessful. Unexplained infertility is a diagnosis of exclusion, and expectant management is reasonable for younger couples with a good prognosis.

Why is "Immediate laparotomy and tubal surgery" not the answer?

There is no tubal disease to repair.

Why is "Hysterectomy" not the answer?

Hysterectomy is not a treatment for infertility.

Why is "Long-term clomiphene alone for 3 years" not the answer?

Prolonged clomiphene beyond about 6 to 12 cycles is not recommended.

What concept does this question test?

It tests Infertility: unexplained infertility in OBG. Stimulated IUI for three to six cycles is the first active treatment, and IVF is offered after failure or earlier if the woman is older or the duration is long. Laparoscopy may be considered to exclude endometriosis.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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: unexplained infertility?

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.