PCOS Quiz

A 27-year-old woman with PCOS wants pregnancy. BMI 32, HOMA-IR elevated. Which of the following is the first-line ovulation induction agent according to current evidence?

• Clomiphene citrate

• Letrozole

• Metformin

• Laparoscopic ovarian drilling

• Gonadotropins

In a PCOS patient with normal BMI but abnormal OGTT, which intervention directly improves insulin sensitivity and lowers androgen levels?

• Pioglitazone

• Metformin

• COCP with drospirenone

• Clomiphene citrate

• Spironolactone

A 22-year-old PCOS patient complains of severe hirsutism and irregular menses. She is not seeking fertility. Which treatment is most effective as first-line?

• Metformin monotherapy

• COCPs containing antiandrogenic progestin

• Clomiphene citrate

• Spironolactone monotherapy

• Laparoscopic ovarian drilling

Which long-term pharmacological intervention has the strongest evidence for reducing the risk of type 2 diabetes in PCOS patients with impaired glucose tolerance?

• Clomiphene citrate

• COCPs

• Metformin

• Spironolactone

• Flutamide

A PCOS woman fails to conceive after 6 cycles of Letrozole. Which is the next recommended step before moving to IVF?

• Add Metformin

• Add low-dose dexamethasone

• Switch to Clomiphene citrate

• Gonadotropin therapy with careful monitoring

• Laparoscopic ovarian drilling

A PCOS patient on COCP + spironolactone for hirsutism complains of worsening acne. Which drug adjustment would be most beneficial?

• Stop spironolactone

• Change to COCP with cyproterone acetate

• Add Metformin

• Add Clomiphene citrate

• Switch to gonadotropins

A 16-year-old with irregular menses and mild hirsutism is diagnosed with PCOS. She is not sexually active. Which treatment is preferred?

• Clomiphene citrate

• Metformin

• COCP

• Spironolactone monotherapy

• GnRH agonist

Which non-fertility-directed therapy in PCOS most effectively improves lipid profile and endothelial function?

• Metformin

• Clomiphene citrate

• COCPs

• Spironolactone

• Gonadotropins

A woman with PCOS is resistant to both Clomiphene and Letrozole. Which surgical option is evidence-based before IVF?

• Bilateral ovarian cystectomy

• Laparoscopic ovarian drilling

• Ovarian wedge resection

• Hysteroscopic adhesiolysis

• Endometrial ablation

Which drug is continued during early pregnancy in PCOS patients to reduce miscarriage in insulin-resistant women?

• Clomiphene citrate

• Letrozole

• Metformin

• Spironolactone

• COCPs