Infertility and contraception: clomiphene anti-oestrogenic effects: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Infertility and contraception: clomiphene anti-oestrogenic effects

Sample item

A woman ovulates on clomiphene but remains infertile. Midcycle cervical mucus is scanty and the endometrium is thin. Which property of the drug explains this?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Anti-oestrogenic action at the cervix and endometrium

Clomiphene is a SERM that blocks oestrogen receptors centrally, which raises gonadotropins, but it also blocks receptors in the cervix and endometrium. This can cause hostile mucus and a thin endometrium despite ovulation.

Option by option

  • A. Direct suppression of FSH release

    Clomiphene increases, not suppresses, FSH release.

  • B. Progestogenic action at the endometrium

    Clomiphene has no meaningful progestogenic activity.

  • C. Anti-oestrogenic action at the cervix and endometrium (correct)

    Correct. Peripheral oestrogen receptor blockade reduces mucus and endometrial growth.

  • D. Androgenic action on the cervix

    Androgenic effects are not the mechanism of clomiphene.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Anti-oestrogenic action at the cervix and endometrium. Clomiphene is a SERM that blocks oestrogen receptors centrally, which raises gonadotropins, but it also blocks receptors in the cervix and endometrium.

Why is "Direct suppression of FSH release" not the answer?

Clomiphene increases, not suppresses, FSH release.

Why is "Progestogenic action at the endometrium" not the answer?

Clomiphene has no meaningful progestogenic activity.

Why is "Androgenic action on the cervix" not the answer?

Androgenic effects are not the mechanism of clomiphene.

What concept does this question test?

It tests Infertility and contraception: clomiphene anti-oestrogenic effects in OBG. This can cause hostile mucus and a thin endometrium despite ovulation.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Infertility and contraception: clomiphene anti-oestrogenic effects?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.