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

AIIMS CRE 2025

Obstetrics and Midwifery Nursing

Easy

Appeared in: AIIMS CRE 2025

Explanation

Follicle Stimulating Hormone (FSH) is a primary hormone measured to assess ovarian reserve.
FSH is produced by the pituitary gland and stimulates the growth of ovarian follicles.
As ovarian function declines, the ovaries produce less estrogen and inhibin, leading to a feedback loop that causes the pituitary to release higher levels of FSH.
An elevated basal (Day 3) FSH level is indicative of diminished ovarian reserve, as the brain is trying harder to stimulate the ovaries.
This makes FSH a crucial marker in infertility workups to estimate the remaining egg supply.

Option A: Prolactin is involved in lactation. While elevated levels can disrupt ovulation, it does not reflect the quantity of eggs in the ovaries (ovarian reserve).
Option B: TSH assesses thyroid function. Thyroid disorders can cause menstrual irregularities and infertility, but TSH is not a direct marker of ovarian reserve.
Option D: Testosterone is an androgen. It is measured to diagnose conditions of androgen excess, like Polycystic Ovary Syndrome (PCOS), not to assess ovarian reserve.

Visual 1: Diagram: A flowchart showing the hypothalamic-pituitary-ovarian axis. This would illustrate how GnRH from the hypothalamus stimulates FSH from the pituitary, which then acts on the ovary. It would also show the negative feedback loop from estrogen and inhibin, explaining why FSH rises when ovarian function declines.
Visual 2: Chart: A graph illustrating typical hormone levels (FSH, LH, Estrogen, Progesterone) throughout a normal menstrual cycle compared to a cycle in a woman with diminished ovarian reserve, highlighting the elevated basal FSH.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain The concept tested is the hormonal evaluation of female infertility, specifically the assessment of ovarian reserve as background academic context rather than a clinical decision trigger.
For nurses in fertility clinics, understanding these hormonal tests is crucial for patient education. You will need to explain the purpose of each test, what the results mean for the patient's fertility potential, and the next steps in their treatment plan.
Nurses must ensure proper timing for blood draws. While AMH can be tested anytime, FSH must be drawn on day 2, 3, or 4 of the menstrual cycle for an accurate basal reading. Patient education on this point is a key nursing responsibility.
What if? If a patient has a high FSH but a normal AMH, the clinical picture is more complex. This might suggest a transient FSH elevation or other issues. The nurse's role would be to ensure the results are communicated to the provider for interpretation and to support the patient through the uncertainty, reinforcing the need for a comprehensive evaluation rather than focusing on a single test result.

How to Approach the Question

First, identify the core question: It asks for a hormone that measures 'ovarian reserve'. This is the key concept.
Recall the function of the main reproductive hormones. Think about the feedback loops involved in the menstrual cycle.
Analyze the options: Prolactin (milk), TSH (thyroid), FSH (follicles), Testosterone (androgen).
Connect the hormone's function to 'ovarian reserve' (egg supply). FSH directly stimulates the follicles that contain eggs.
Reason through the feedback mechanism: If the egg supply is low (low reserve), the ovaries signal less. The brain (pituitary) compensates by 'shouting' louder with more FSH. Therefore, high FSH means low reserve.
Eliminate the other options by confirming their primary roles are unrelated to measuring the quantity of eggs (e.g., thyroid function, androgen levels, lactation).

Concept Tested & Keywords

Concept Tested: The concept tested is the hormonal evaluation of female infertility, specifically the assessment of ovarian reserve.
Stem keywords: hormone, infertility investigations, ovarian reserve
Lead-in keywords: Which

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