Question:
Ovarian reserve is best indicated by which of the following?
Ovarian reserve is best indicated by which of the following?
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The day 3 gonadotropin that rises as the follicle pool falls.
Updated On: Jun 24, 2026
- LH
- FSH
- LH/FSH ratio
- Estrogen
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The Correct Option is B
Solution and Explanation
Step 1: Ovarian reserve reflects the size of the resting primordial follicle pool, indicating the quantity and quality of remaining oocytes and the functional reproductive potential of the ovary.
Step 2: Among the listed hormones, basal serum FSH measured on day 2 or 3 of the menstrual cycle is the classic marker. As the follicle pool declines, less inhibin and estradiol are produced, so feedback inhibition on the pituitary falls and FSH rises. A high early follicular FSH therefore signals a diminished reserve.
Step 3: This is the basis of the clomiphene citrate challenge test, which measures FSH on cycle day 10 after antiestrogen clomiphene from day 5 to 9 to unmask a poor reserve.
Step 4: LH, the LH/FSH ratio and estrogen are not reliable reserve markers (LH/FSH ratio is used for polycystic ovary syndrome), so day 3 FSH is the best indicator among the options. Note that anti-Mullerian hormone and antral follicle count are even better modern markers, but FSH is the correct choice here.
Step 2: Among the listed hormones, basal serum FSH measured on day 2 or 3 of the menstrual cycle is the classic marker. As the follicle pool declines, less inhibin and estradiol are produced, so feedback inhibition on the pituitary falls and FSH rises. A high early follicular FSH therefore signals a diminished reserve.
Step 3: This is the basis of the clomiphene citrate challenge test, which measures FSH on cycle day 10 after antiestrogen clomiphene from day 5 to 9 to unmask a poor reserve.
Step 4: LH, the LH/FSH ratio and estrogen are not reliable reserve markers (LH/FSH ratio is used for polycystic ovary syndrome), so day 3 FSH is the best indicator among the options. Note that anti-Mullerian hormone and antral follicle count are even better modern markers, but FSH is the correct choice here.
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