Infertility and contraception: OHSS prevention: 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 and contraception: OHSS prevention

Sample item

A woman with PCOS on a GnRH antagonist IVF cycle has 28 follicles on the day of trigger. Which change lowers her risk of ovarian hyperstimulation syndrome?

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

The answer and the reasoning

A. Triggering with a GnRH agonist instead of hCG

OHSS is driven by VEGF released under prolonged hCG stimulation. A GnRH agonist trigger causes a short LH surge and shortens luteal activity, greatly reducing risk. It is possible only in antagonist cycles and is often combined with freezing all embryos.

Option by option

  • A. Triggering with a GnRH agonist instead of hCG (correct)

    Correct. The short LH surge avoids prolonged luteal stimulation.

  • B. Triggering with a higher dose of hCG

    A higher hCG dose prolongs luteal stimulation and raises risk.

  • C. Giving luteal hCG injections

    Luteal hCG maintains the corpora lutea and increases OHSS.

  • D. Adding clomiphene citrate

    Clomiphene stimulates more follicular growth and would worsen the problem.

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 A, Triggering with a GnRH agonist instead of hCG. OHSS is driven by VEGF released under prolonged hCG stimulation.

Why is "Triggering with a higher dose of hCG" not the answer?

A higher hCG dose prolongs luteal stimulation and raises risk.

Why is "Giving luteal hCG injections" not the answer?

Luteal hCG maintains the corpora lutea and increases OHSS.

Why is "Adding clomiphene citrate" not the answer?

Clomiphene stimulates more follicular growth and would worsen the problem.

What concept does this question test?

It tests Infertility and contraception: OHSS prevention in OBG. A GnRH agonist trigger causes a short LH surge and shortens luteal activity, greatly reducing risk. It is possible only in antagonist cycles and is often combined with freezing all embryos.

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 and contraception: OHSS prevention?

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.