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MRCOG PART 2 SBAs and EMQs

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EMQ on infertility.

EMQ on infertility. Posted by Jamil Ahmad A.

A 24 year old woman with her 35 year old partner has been referred to the infertility clinic because of 2 years of primary infertility. The woman has an irregular menstrual cycle every 2-4 months and her partner?s semen analysis is normal. The woman?s BMI is 26 and there is no significant past medical history. Investigations have confirmed a diagnosis of polycystic ovary. The couple have not achieved a pregnancy despite a 6 months course of clomephene citrate with evidence of ovulation based on day 21 progesterone concentration and ultrasound scanning .

Answer is Lap Dye for tubal patency. But Nice guideline clearly states that tubal patency should be ensured before clomifine.

Posted by PAUL A.

Which option did you select as the correct answer and why? Did the question state that tubal patency had been confirmed or did you assume this?

EMQ on infertility Posted by Jamil Ahmad A.

I selected IUI and I assumed that tubal patency has been confirmed as we should give clomifine only after confirming the tubal patency.

Posted by PAUL A.

For IUI to be the correct answer you have to make 2 assumptions

1) Tubal patency test undertaken and normal

2) Woman continues taking clomifene

 

Neither of these are stated in the question.

 

IUI is not appropriate treatment for infertility associated with anovulation.

EMQ on infertility. Posted by Jamil Ahmad A.

Thanks for the  explaination ,I thought the question said that there is evidence of ovulation based on prog level and USG.