LATEST OB/GYN – REPRODUCTIVE
ENDOCRINOLOGY & INFERTILITY
CERTIFICATION EXAM OFFERED BY
AMERICAN BOARD OF OBSTETRICS &
GYNECOLOGY (ABOG) | COMPLETE EXAM Q&A
WITH RATIONALES
1. A 32-year-old female presents with secondary
amenorrhea for 6 months. She has hirsutism and
acne. Body mass index is 32. Labs: FSH 6 mIU/mL, LH
18 mIU/mL, testosterone 80 ng/dL. What is the most
likely diagnosis?
A) Polycystic ovary syndrome (PCOS)
B) Premature ovarian insufficiency
C) Hypothalamic amenorrhea
D) Androgen-secreting tumor
Correct answer: A
Rationale: PCOS is diagnosed by
oligomenorrhea/amenorrhea, hyperandrogenism
(hirsutism, acne, high testosterone), and elevated
LH:FSH ratio (>2:1).
2. A 28-year-old G0 female with PCOS and
oligomenorrhea desires pregnancy. She has a normal
,hysterosalpingogram and normal semen analysis.
What is the most appropriate first-line ovulation
induction agent?
A) Letrozole (aromatase inhibitor)
B) Clomiphene citrate
C) Gonadotropins (FSH)
D) Metformin
Correct answer: A
Rationale: Letrozole (aromatase inhibitor) is first-line
for ovulation induction in PCOS (higher live birth rate
and lower multiple pregnancy rate than clomiphene).
3. A 35-year-old female with a history of pelvic
inflammatory disease (PID) presents with 2 years of
primary infertility. Hysterosalpingogram shows
bilateral proximal tubal occlusion. What is the most
appropriate next step?
A) In vitro fertilization (IVF)
B) Laparoscopic tubal cannulation
C) Tubal reanastomosis
D) Clomiphene citrate
Correct answer: A
,Rationale: Proximal tubal occlusion after PID has a
poor prognosis for surgical repair; IVF is the
treatment of choice.
4. A 42-year-old female with diminished ovarian
reserve (AMH 0.5 ng/mL, FSH 15 mIU/mL) desires
pregnancy. What is the most appropriate next step?
A) In vitro fertilization (IVF) with donor oocytes
B) Clomiphene citrate
C) Letrozole
D) Gonadotropin intrauterine insemination (IUI)
Correct answer: A
Rationale: Diminished ovarian reserve with low AMH
and elevated FSH suggests poor response to ovarian
stimulation; donor oocyte IVF has highest success
rate.
5. A 30-year-old G0 female with endometriosis-
related infertility and a normal ovarian reserve has
failed 3 cycles of letrozole with IUI. What is the most
appropriate next step?
A) In vitro fertilization (IVF)
B) Laparoscopic excision of endometriosis
C) Gonadotropin IUI
, D) Clomiphene citrate
Correct answer: A
Rationale: For endometriosis-related infertility, IVF is
more effective than continued IUI after 3-4 failed
cycles.
6. A 38-year-old female presents with secondary
amenorrhea for 1 year. She has hot flashes and night
sweats. FSH is 80 mIU/mL. What is the most likely
diagnosis?
A) Premature ovarian insufficiency (POI)
B) Polycystic ovary syndrome (PCOS)
C) Hypothalamic amenorrhea
D) Asherman syndrome
Correct answer: A
Rationale: Premature ovarian insufficiency (age <40)
with elevated FSH (>40) and symptoms of estrogen
deficiency (hot flashes).
7. A 32-year-old G0 female with a history of Asherman
syndrome (intrauterine adhesions) after a D&C for
missed abortion desires pregnancy. What is the most
appropriate next step?
A) Hysteroscopic adhesiolysis
ENDOCRINOLOGY & INFERTILITY
CERTIFICATION EXAM OFFERED BY
AMERICAN BOARD OF OBSTETRICS &
GYNECOLOGY (ABOG) | COMPLETE EXAM Q&A
WITH RATIONALES
1. A 32-year-old female presents with secondary
amenorrhea for 6 months. She has hirsutism and
acne. Body mass index is 32. Labs: FSH 6 mIU/mL, LH
18 mIU/mL, testosterone 80 ng/dL. What is the most
likely diagnosis?
A) Polycystic ovary syndrome (PCOS)
B) Premature ovarian insufficiency
C) Hypothalamic amenorrhea
D) Androgen-secreting tumor
Correct answer: A
Rationale: PCOS is diagnosed by
oligomenorrhea/amenorrhea, hyperandrogenism
(hirsutism, acne, high testosterone), and elevated
LH:FSH ratio (>2:1).
2. A 28-year-old G0 female with PCOS and
oligomenorrhea desires pregnancy. She has a normal
,hysterosalpingogram and normal semen analysis.
What is the most appropriate first-line ovulation
induction agent?
A) Letrozole (aromatase inhibitor)
B) Clomiphene citrate
C) Gonadotropins (FSH)
D) Metformin
Correct answer: A
Rationale: Letrozole (aromatase inhibitor) is first-line
for ovulation induction in PCOS (higher live birth rate
and lower multiple pregnancy rate than clomiphene).
3. A 35-year-old female with a history of pelvic
inflammatory disease (PID) presents with 2 years of
primary infertility. Hysterosalpingogram shows
bilateral proximal tubal occlusion. What is the most
appropriate next step?
A) In vitro fertilization (IVF)
B) Laparoscopic tubal cannulation
C) Tubal reanastomosis
D) Clomiphene citrate
Correct answer: A
,Rationale: Proximal tubal occlusion after PID has a
poor prognosis for surgical repair; IVF is the
treatment of choice.
4. A 42-year-old female with diminished ovarian
reserve (AMH 0.5 ng/mL, FSH 15 mIU/mL) desires
pregnancy. What is the most appropriate next step?
A) In vitro fertilization (IVF) with donor oocytes
B) Clomiphene citrate
C) Letrozole
D) Gonadotropin intrauterine insemination (IUI)
Correct answer: A
Rationale: Diminished ovarian reserve with low AMH
and elevated FSH suggests poor response to ovarian
stimulation; donor oocyte IVF has highest success
rate.
5. A 30-year-old G0 female with endometriosis-
related infertility and a normal ovarian reserve has
failed 3 cycles of letrozole with IUI. What is the most
appropriate next step?
A) In vitro fertilization (IVF)
B) Laparoscopic excision of endometriosis
C) Gonadotropin IUI
, D) Clomiphene citrate
Correct answer: A
Rationale: For endometriosis-related infertility, IVF is
more effective than continued IUI after 3-4 failed
cycles.
6. A 38-year-old female presents with secondary
amenorrhea for 1 year. She has hot flashes and night
sweats. FSH is 80 mIU/mL. What is the most likely
diagnosis?
A) Premature ovarian insufficiency (POI)
B) Polycystic ovary syndrome (PCOS)
C) Hypothalamic amenorrhea
D) Asherman syndrome
Correct answer: A
Rationale: Premature ovarian insufficiency (age <40)
with elevated FSH (>40) and symptoms of estrogen
deficiency (hot flashes).
7. A 32-year-old G0 female with a history of Asherman
syndrome (intrauterine adhesions) after a D&C for
missed abortion desires pregnancy. What is the most
appropriate next step?
A) Hysteroscopic adhesiolysis
