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Dr.Niraj Mahajan
Dr.Niraj Mahajan
Dr.Niraj Mahajan


Ovulation and Ovulation date

By AdminPosted On 05-Oct-2016

1. Best evidence of ovulation date

a) Billings ovulation method - Cervical Mucus method

b) Basal Body Temperature

c) Ovulation Abdominal Plan

d) Follicular monitoring by TVS

e) LH test kit to detect LH surge

Correct Answer: d. Follicular monitoring by TVS (Trans-vaginal Sonography) is a gold standard for detecting ovulation date. LH test kit has very high sensitivity in detecting LH surge but it does not detect ovulation date.

2. Ovulation may be indicated by all the following, EXCEPT

a) Endometrial biopsy revealing secretary changes.

b) Upward shift in the basal temperature.

c) Changing of cervical mucous to thick and scanty.

d) Progesterone level > 6.5ng/ml.

e) Mid-cycle elevation in Prolactin.

Correct Answer: e) Mid-cycle elevation in Prolactin. High prolactin levels inhibit secretion of FSH thereby suppressing ovulation. Cervical mucus, just before ovulation date, is healthier for sperm, helps them survive, and easier to swim through. Right after ovulation, the cervical mucus changes back to the less fertile kind. When cervical mucus is in the wet or egg white consistency stage, ovulation date is approaching. This is the best time to have intercourse, if pregnancy is planned.

3. Which of the following is suggestive of ovulation

a) Basal body temperature drop at least 0.5C in the second half of the cycle

b) Day 21 estrogen level is elevated

c) Progesterone level on day ten of the cycle is elevated

d) Regular cycle with dysmenorrhea

e) Oligomenorrhoea

Correct Answer: d) Regular cycle with dysmenorrhea. Molecular compounds called prostaglandins are released during menstruation, due to the destruction of the endometrial cells, and the resultant release of their contents. Release of prostaglandins and other inflammatory mediators in the uterus cause the uterus to contract.

4. Ovulation occurs

a) Immediately after LH surge.

b) 6-8 hours after LH surge.

c) After Prolactin surge.

d) After follicles ripened in the ovary.

e) 36 hours after LH surge

Correct Answer: e) 36 hours after LH surge. LH can be detected by urinary ovulation date predictor kits (LH-kit) that are performed, typically daily, around the time ovulation date may be expected. A conversion from a negative to a positive reading would suggest that ovulation is about to occur within 24–36 hours, giving women two days to engage in sexual intercourse or artificial insemination. Sometimes we give exogenous LH surge in the form of Inj. HCG 10000 IU once the graffian follicle is completely mature.

5. Luteinisation of Follicle

Which hormone is responsible for the ovulation and initiation of luteinisation of the follicle?

a) Estrogen

b) Follicle-stimulating hormone

c) Gonadotrophin-releasing hormone

d) Luteinising hormone

e) Progesterone

Correct Answer: d) Luteinising hormone (LH). Circulating estrogen levels rise in the follicular phase and are responsible for the preovulatory surge of LH. This then triggers the ovulation and initiates the luteinisation. Progesterone may have some role in the LH surge, but the main factor is LH, which is responsible for the above actions.

6. Graafian Follicle

Which one of the following statements is NOT correct?

a) The graafian follicle after ovulation changes to corpus luteum.

b) Atretic follicles are formed after atrophy of corpus luteum.

c) Estradiol is formed from androgens in the ovarian follicle.

d) Follicular stimulating hormone (FSH) is necessary for the development of the granulosa layer.

Correct Answer: b) Atretic follicles are formed after atrophy or breakdown of the ovarian follicles. Atretic corpus luteum is called as corpus albicans. Estradiol, is derived from cholesterol. A fraction of the androstenedione is converted to testosterone, which in turn undergoes conversion to estradiol by an enzyme called aromatase.

7. Which part of the ovary is responsible for androgen production?

a) Granulosa cells

b) Leydig cells

c) Organ of Zuckerkandl cells

d) Sertoli cells

e) Theca cells

Correct Answer: e) Theca cells. Luteneising hormone drives the conversion of cholesterol into androgens in the theca cells. These androgens are then transferred to the granulosa cells for conversion (aromatisation) into estrogen (estradiol) under the influence of follicle-stimulating hormones.

8. AMH

Which hormone is made in the ovarian granulosa cells before ovulation occurs?

a) Aldosterone

b) Luteinizing hormone (LH)

c) Antimüllerian hormone (AMH)

d) Progesterone

e) Testosterone

Correct Answer: c) Antimüllerian hormone. The granulosa cells also convert androgens produced by the theca cells into estrogen, and after ovulation, they produce progesterone in the granulosa lutein cells. LH is secreted by pituitary gland and not from ovary.

9. An involuted corpus luteum of ovary becomes a hyalinized mass known as

a) Corpus delicti.

b) Corpus granulosa.

c) Graafian follicle.

d) Corpus atrectica.

e) Corpus albicans.

Correct Answer: e) Corpus albicans. 'Corpus delicti' is a term from Western jurisprudence referring to the principle that a crime must have been proven to have occurred before a person can be convicted of committing that crime.

10. Spinnbarkeit is a term which means

a) Crystallization of the cervical mucous.

b) Thickening of the cervical mucous.

c) Mucous secretion of the cervix.

d) Threading of the cervical mucous.

e) Thinning of the cervical mucous.

Correct Answer: d) Threading of the cervical mucous. Spinnbarkeit refers to the stringy or stretchy property found to varying degrees in mucus, saliva, albumen and similar viscoelastic fluids. The term is used especially with reference to cervical mucus at the time just prior to or during ovulation, and to sputum, particularly in cases of cystic fibrosis.

Under the influence of estrogens, cervical mucus becomes abundant, clear, and stretchable, somewhat like egg white.

11. Ovarian Hyperstimulation

All the following are true, about ovarian hyperstimulation, EXCEPT

a) It can follow any of ovulation induction drugs

b) In severe type admission to the intensive care unit may be required

c) The ovaries will be very small in size have unilateral cyst

d) It can diagnosed clinically and by ultrasound

e) Patients with PCO are at increased risk

Correct Answer: c) The ovaries will be very small in size have unilateral cyst. OHSS is characterized by the presence of multiple luteinized cysts within the ovaries leading to ovarian enlargement and secondary complications.

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Dr. Niraj Mahajan

MD- Gynecologist, Laparoscopic Surgeon, Uro-gynecologist , Infertility specialist & Cosmetic Gynecologist.

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