A 32-year-old woman is being evaluated for infertility. Her day 3 FSH is 18 IU/L, LH is 7 IU/L, and anti-Müllerian hormone (AMH) is 0.4 ng/mL. Antral follicle count on ultrasound is 3. These findings are MOST consistent with:

• A Polycystic ovary syndrome
• B Diminished ovarian reserve ✓
• C Hypothalamic amenorrhoea
• D Hyperprolactinaemia

Explanation

Diminished ovarian reserve (DOR) is characterised by elevated basal FSH (>10 IU/L), low AMH (<1.0 ng/mL), and low antral follicle count (AFC <5–7) on ultrasound. The elevated FSH reflects reduced negative feedback from the failing ovarian pool. PCOS presents with elevated AMH (often >3.5 ng/mL), high AFC (>12 per ovary), and normal/low FSH. Hypothalamic amenorrhoea and hyperprolactinaemia present with low/normal FSH and amenorrhoea.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.