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Tubal factor infertility — MCCQE Part 1 MCQ

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ModerateInfertilityTubal factor infertilityMCCQE Part 1

A 33-year-old woman with previous pelvic inflammatory disease cannot conceive for 18 months despite regular ovulation and normal semen analysis. Which of the following is the most appropriate next step?

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Correct answer: EAssess tubal patency with hysterosalpingography or appropriate fertility pathway

Assess tubal patency with hysterosalpingography or appropriate fertility pathway is the single best answer because the age, timing, examination findings and investigations in the vignette fit Tubal factor infertility better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian Fertility and Andrology Society guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian Fertility and Andrology Society guidance