A 31-year-old woman with regular cycles and normal ovarian reserve has unexplained infertility for 2 years. Her partner's semen analysis is normal. She has completed 3 cycles of clomiphene-IUI without conception. The next recommended step is:
- A In vitro fertilization ✓
- B Gonadotropin-IUI for 3 cycles
- C Continue clomiphene-IUI for 3 more cycles
- D Laparoscopy to rule out endometriosis
Correct answer: A. In vitro fertilization
Explanation
After failed ovulation induction with clomiphene-IUI (typically 3 to 6 cycles), IVF is the next step for unexplained infertility. Gonadotropin-IUI carries high multiple pregnancy risk. Laparoscopy is not routinely indicated without symptoms of endometriosis. Continuing the same failed regimen is not recommended.
Reference: NICE Fertility Guidelines, 2017 (updated 2023) ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.