O&G : OBA

A 39 year old lawyer presents to Gynaecology clinic with a history of subfertility for the last 6 years and is keen to conceive. Ix revealed that she had anovulatory cycle and a normal semen analysis. What would be the most appropriate fertility treatment that you would offer for this patient?

A.Clomid to induce ovulation

B.GnRH injections to induce ovulation

C.Intrauterine insemination

D.IVF

E.Timed sexual intercourse

Key Points :
# subfertility --> male and female factors.
- male (semen - normal)
- female (ovulation / tubal / hypothalamic pituitary axis)
# 39 years old --> advanced maternal age.. reaching 40.. must do conception urgently
# keen to conceive --> need assisted conception
# most appropriate fertility treatment --> DEFINITIVE TX
- if Q asked most appropriate step --> not definitive..STEP

Choices :

1st : find the outlier (absolutely wrong!!!) --> timed sexual intercourse

2nd : find the "nampak sama tapi tak serupa"
- clomid : 1st line.. but need more time.. need to wait
- GnRH : 2nd line...still need to wait..need time..

so between IUI and IVF
best answer is IVF because it is "superior" (i'm not so sure)