Infertility and contraception: multiple pregnancy risk: 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.

Try it

OBG · Infertility and contraception: multiple pregnancy risk

Sample item

Which method of ovulation induction carries the highest risk of multiple pregnancy, including higher-order multiples?

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

The answer and the reasoning

C. Injectable gonadotropins

Gonadotropins recruit multiple follicles and cause twin and higher-order pregnancies in a considerable proportion of cycles unless ultrasound monitoring leads to cancellation. Clomiphene gives a lower twin rate, and letrozole and metformin lower still.

Option by option

  • A. Letrozole

    Letrozole usually yields a single follicle with a low twin rate.

  • B. Clomiphene citrate

    Clomiphene has a smaller multiple pregnancy rate, mainly twins.

  • C. Injectable gonadotropins (correct)

    Correct. Gonadotropin stimulation commonly recruits several follicles.

  • D. Metformin

    Metformin improves ovulation without multiple follicular recruitment.

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.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Injectable gonadotropins. Gonadotropins recruit multiple follicles and cause twin and higher-order pregnancies in a considerable proportion of cycles unless ultrasound monitoring leads to cancellation.

Why is "Letrozole" not the answer?

Letrozole usually yields a single follicle with a low twin rate.

Why is "Clomiphene citrate" not the answer?

Clomiphene has a smaller multiple pregnancy rate, mainly twins.

Why is "Metformin" not the answer?

Metformin improves ovulation without multiple follicular recruitment.

What concept does this question test?

It tests Infertility and contraception: multiple pregnancy risk in OBG. Clomiphene gives a lower twin rate, and letrozole and metformin lower still.

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: multiple pregnancy risk?

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.