A 32-year-old woman with secondary amenorrhea for 8 months has FSH 58 IU/L, LH 42 IU/L, estradiol 18 pg/mL, and normal prolactin. Karyotype is 46,XX. The MOST appropriate term for her condition and the PRIMARY fertility treatment option is:

• A Primary ovarian insufficiency (POI) — oocyte donation IVF ✓
• B Hypogonadotropic hypogonadism — pulsatile GnRH therapy
• C Primary ovarian insufficiency (POI) — high-dose gonadotropin stimulation
• D Hypergonadotropic hypogonadism — GnRH antagonist suppression before IVF

Explanation

Elevated FSH (>25 IU/L on two occasions) with amenorrhea in a woman under 40 years defines primary ovarian insufficiency (POI). This 46,XX woman has hypergonadotropic hypogonadism. Conventional IVF with autologous oocytes has extremely poor success rates in POI due to markedly reduced ovarian reserve. Oocyte donation (donor egg IVF) is the most effective fertility treatment with excellent success rates (60–70% per cycle). High-dose gonadotropin stimulation rarely produces adequate response. Pulsatile GnRH is used for hypogonadotropic hypogonadism.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.