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Premature ovarian insufficiency and fertility — DRCOG MCQ

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HardSubfertilityPremature ovarian insufficiency and fertilityDRCOG

A 34-year-old woman has 9 months of amenorrhoea and hot flushes while trying to conceive. Pregnancy test is negative. FSH is elevated on two samples 6 weeks apart. What is the most likely diagnosis?

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Correct answer: A — Premature ovarian insufficiency

Amenorrhoea, vasomotor symptoms and repeatedly raised FSH before age 40 indicate premature ovarian insufficiency. PCOS usually has normal or low-normal FSH and hyperandrogenism rather than hypoestrogenic symptoms. Tubal occlusion does not cause hot flushes or raised FSH. Fertility counselling and HRT discussion are needed.

Reference: NICE NG23; NICE CG156