Which hormone is typically measured during infertility investigations to assess ovarian reserve?

RRB Nsg. Superintendent-2026 (Shift -2nd)

Obstetrics & Gynaecology

Easy

Appeared in: RRB Nsg. Superintendent-2026 (Shift -2nd)

Explanation

Follicle-Stimulating Hormone (FSH) is a hormone secreted by the anterior pituitary gland that directly stimulates the growth and maturation of ovarian follicles.
It is a primary marker used to evaluate ovarian reserve, with blood levels typically measured on day 2 or 3 of the menstrual cycle.
An elevated basal FSH level suggests that the pituitary gland is working harder to stimulate a response from the ovaries, which is a sign of diminished ovarian reserve (fewer remaining eggs).
This occurs due to a decrease in negative feedback from hormones like estrogen and inhibin B, which are produced by the developing follicles.

Option A: Prolactin is measured to check for hyperprolactinemia. While high levels can cause irregular periods and anovulation, it does not provide information about the quantity of eggs in the ovaries.
Option B: TSH is measured to assess thyroid function. Both hypothyroidism and hyperthyroidism can disrupt the menstrual cycle and cause infertility, but TSH levels do not reflect the ovarian egg supply.
Option D: Testosterone is measured to evaluate for hyperandrogenism (excess male hormones), a hallmark of conditions like Polycystic Ovary Syndrome (PCOS). It relates to ovulatory dysfunction, not the size of the egg reservoir.

Visual 1: Diagram: The Hypothalamic-Pituitary-Ovarian (HPO) axis feedback loop. This visual would clarify how estrogen and inhibin from the ovaries provide negative feedback to the pituitary, which in turn regulates FSH secretion.
Visual 2: Chart: An illustration of the inverse relationship between ovarian reserve and basal FSH levels. The chart would show FSH levels gradually increasing as a woman ages and her egg count declines.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Hormonal assessment of ovarian reserve in female infertility as background academic context rather than a clinical decision trigger.
Nurses are crucial in educating patients about the timing of hormonal tests. For an accurate basal FSH level, the blood sample must be drawn on day 2 or 3 of the menstrual cycle.
Communicating test results requires sensitivity. An elevated FSH level can be distressing for patients, and nurses must be prepared to provide support and explain the next steps in the care plan.
While FSH is a traditional marker, it is often interpreted alongside Anti-Müllerian Hormone (AMH) and an antral follicle count (AFC) via ultrasound for a more comprehensive assessment of ovarian reserve.

How to Approach the Question

This is a factual recall question testing knowledge of reproductive endocrinology.
First, identify the core concept in the question stem: 'ovarian reserve.' This refers to the quantity (and quality) of a woman's remaining eggs.
Next, analyze the function of each hormone listed in the options in the context of female reproduction.
Recall the principle of the Hypothalamic-Pituitary-Ovarian (HPO) axis. The pituitary releases FSH to stimulate the ovaries.
Apply the concept of negative feedback. When the ovaries have a low reserve, they respond poorly and produce less estrogen and inhibin. This lack of negative feedback signals the pituitary to release even more FSH.
Conclude that a high level of FSH is a marker for low ovarian reserve.

Concept Tested & Keywords

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