Reproductive Physiology — MCQs

A 42-year-old woman with previously regular 28-day cycles now reports cycles varying from 24-35 days over the past year. Day 3 labs show: FSH 18 mIU/mL (normal: 3-10), LH 10 mIU/mL, estradiol 35 pg/mL, AMH 0.4 ng/mL (normal age 40-44: 0.5-2.5). She has three children and desires no future pregnancies but wants to understand her physiology. Evaluate these findings and synthesize the underlying pathophysiologic process.

A 26-year-old woman with regular menses undergoes hormonal evaluation on day 3 of her cycle: FSH 8 mIU/mL, LH 6 mIU/mL, estradiol 45 pg/mL. On day 14, repeat testing shows: FSH 10 mIU/mL, LH 42 mIU/mL, estradiol 250 pg/mL. On day 21: progesterone 16 ng/mL, estradiol 150 pg/mL. Analyze this hormonal pattern to identify the physiologic mechanism driving the day 14 LH surge.

A 35-year-old woman undergoes in vitro fertilization with embryo transfer on day 3 post-retrieval. Her ovarian stimulation protocol included recombinant FSH and GnRH antagonist, with hCG trigger 36 hours before retrieval. On the day of transfer (day 3), what would be the expected dominant hormone maintaining the endometrium, and what is its primary source?

A 32-year-old woman at 8 weeks gestation presents with nausea and vomiting. Laboratory studies show: hCG 150,000 mIU/mL (expected for gestational age: 50,000-100,000 mIU/mL), TSH 0.1 mIU/L (normal: 0.4-4.0), free T4 1.8 ng/dL (normal: 0.8-1.8). She has no personal or family history of thyroid disease. Apply your understanding of pregnancy hormones to explain these findings.

A 32-year-old pregnant woman at 28 weeks gestation with type 1 diabetes presents with recurrent severe hypoglycemia despite reducing her insulin dose. Her insulin requirements have decreased by 40% over the past week. She reports decreased fetal movement. Fetal ultrasound shows intrauterine fetal demise. Evaluate the physiological mechanism explaining her changing insulin requirements in the context of pregnancy loss.

What is the pH of the vagina during reproductive life?

The onset of the luteinizing hormone (LH) surge precedes ovulation by approximately how many hours?

Capacitation of sperms occurs in which of the following locations?

Recruitment of follicles is caused by?

Arrange the following in sequential order of their involvement in estrogen synthesis: Progesterone, Androgen in granulosa cell, Androgen in theca cell, Aromatase?