Menstrual Disorders & Infertility · NEET PG Preparation Obstetrics & Gynaecology
A 28-year-old nulliparous woman presents with secondary amenorrhea and infertility of 2 years duration, following a dilatation and curettage (D&C) do…
Practice question from Menstrual Disorders & Infertility (NEET PG Preparation Obstetrics & Gynaecology), with the correct answer and a step-by-step solution.
medium · MCQ · Q-FA88A6
A 28-year-old nulliparous woman presents with secondary amenorrhea and infertility of 2 years duration, following a dilatation and curettage (D&C) done for postpartum hemorrhage after her first delivery. Hormonal profile (FSH, LH, TSH, Prolactin) is entirely normal. Hysteroscopy reveals extensive intrauterine adhesions. What is the most appropriate management for this patient?
- A.Hysteroscopic adhesiolysis followed by high-dose estrogen-progesterone therapy to promote endometrial growthCorrect answer
- B.Gonadotropin-releasing hormone (GnRH) agonist therapy for 6 months alone
- C.Bilateral wedge resection of ovaries
- D.In vitro fertilization (IVF) with surrogate uterus directly
Solution
This patient has Asherman syndrome (intrauterine adhesions), typically following postpartum D&C. The treatment of choice is hysteroscopic lysis of adhesions. To prevent recurrence of adhesions and promote endometrial proliferation, post-procedure estrogen therapy (e.g., conjugated equine estrogens followed by a progestin) is commonly administered, sometimes with an intrauterine device or balloon stent placed temporarily.
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