Free DHA Reproductive Medicine & Infertility mock test

Reproductive Medicine & Infertility sample questions with answers

4 more original exam-style Reproductive Medicine & Infertility questions, worked in full. They are not real or recalled exam questions, and none of them is in the diagnostic above, so sit that first if you have not.

1. Question 1 · Anovulation, PCOS and Ovulation Induction

   A 29-year-old anovulatory woman with PCOS has a BMI of 34 kg/m2. Before or alongside medication, which intervention most improves her chance of ovulation?

   1. AStarting a combined oral contraceptive
   2. BLosing 5 to 10% of body weight
   3. CLaparoscopic ovarian drilling first
   4. DLong-term spironolactone
   Show answer and explanation

   Correct answer: B. Losing 5 to 10% of body weight

   Modest weight loss of 5 to 10% in women with excess weight can restore ovulation and improve response to treatment. The combined pill and spironolactone prevent pregnancy, and drilling is a second-line option.

   Reference: International Evidence-based Guideline for the Assessment and Management of PCOS 2023

2. Question 2 · Assisted Reproductive Technology

   Which patient meets the Bologna criteria for poor ovarian response?

   1. AAge 35 with an AMH of 2.5 ng/mL
   2. BAge 41 with 3 oocytes in a prior standard cycle
   3. CAge 41 with an antral follicle count of 14
   4. DAge 32 with 6 oocytes in a prior cycle
   Show answer and explanation

   Correct answer: B. Age 41 with 3 oocytes in a prior standard cycle

   The Bologna criteria require two of: age 40 or more or another risk factor, a previous poor response of 3 or fewer oocytes with conventional stimulation, and an abnormal reserve test. Age 41 with only 3 oocytes previously meets two criteria, whereas age 41 with a normal follicle count meets only one.

   Reference: Ferraretti AP et al. ESHRE Consensus on Poor Ovarian Response, Hum Reprod 2011

3. Question 3 · Complications of ART

   A woman develops OHSS 12 days after an hCG trigger and fresh embryo transfer. What is the most likely driver of this late-onset presentation?

   1. ALuteal oestradiol supplementation
   2. BResidual exogenous hCG from the trigger
   3. CEndogenous hCG from an early pregnancy
   4. DOvarian torsion during retrieval
   Show answer and explanation

   Correct answer: C. Endogenous hCG from an early pregnancy

   Late OHSS, presenting 10 or more days after the trigger, is driven by rising endogenous hCG from pregnancy and tends to be more severe and prolonged. Early OHSS within 9 days is linked to the exogenous hCG trigger.

   Reference: RCOG Green-top Guideline No. 5: Management of OHSS 2016

4. Question 4 · Complications of ART

   Six weeks after transfer of two embryos, a woman has right iliac fossa pain. Ultrasound shows a live intrauterine pregnancy and a complex right adnexal mass with free fluid. What is the most likely diagnosis?

   1. AOvarian torsion of a stimulated ovary
   2. BRuptured corpus luteum cyst
   3. CHeterotopic pregnancy
   4. DThreatened miscarriage
   Show answer and explanation

   Correct answer: C. Heterotopic pregnancy

   Heterotopic pregnancy is much more common after ART, particularly with multiple embryo transfer, and a visible intrauterine pregnancy must not exclude a coexisting ectopic. A corpus luteum cyst is possible but less likely with an adnexal mass and free fluid after ART.

   Reference: Speroff's Clinical Gynecologic Endocrinology and Infertility, 9th ed.