skip to main content

Polycystic ovary syndrome — SCE Endocrinology MCQ

Instant feedback + full explanation. One question, done properly.

HardReproductive endocrinologyPolycystic ovary syndromeSCE Endocrinology

A 29-year-old woman with PCOS has anovulatory infertility. Tubal patency and semen analysis are normal, and pregnancy has been excluded. Which pharmacological ovulation-induction treatment should be offered first?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Letrozole after excluding pregnancy and discussing off-label use

Explanation lettering: E = shown as A · D = shown as B · A = shown as C · B = shown as D · C = shown as E

A is correct. The international evidence-based guideline recommends letrozole first-line for anovulatory infertility in PCOS when there is no other infertility factor; it improves ovulation, clinical pregnancy and live birth compared with clomifene. Exclude pregnancy and explain off-label status where relevant. Metformin is less effective as sole induction treatment; monitored gonadotrophins or ovarian surgery are generally second-line, and contraception prevents conception.

Reference: https://pmc.ncbi.nlm.nih.gov/articles/PMC10505534/