A 29-year-old woman with unexplained infertility undergoes controlled ovarian stimulation with gonadotropins for IUI. On day 12, she has 4 dominant follicles greater than or equal to 17 mm. The recommended action is to:

• A Cancel the cycle due to high-order multiple pregnancy risk ✓
• B Proceed with hCG trigger and IUI
• C Convert to IVF cycle
• D Administer hCG but withhold IUI

Explanation

When 4 or more dominant follicles develop during gonadotropin-stimulated IUI cycles, the cycle should be cancelled to avoid high-order multiple pregnancy. Some guidelines cancel at 3 or more follicles greater than or equal to 16 to 17 mm. Proceeding with IUI risks triplets or more. Converting to IVF is not standard practice in this scenario.

Reference: Practice Committee of ASRM Guidelines, 2022 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.