Question

A45-year-old G3P3 comes to the office because she has been unable to

conceive for the last two years. She is healthy and has three children,
ages 10, 12 and 14, whom she conceived with her husband. She used a
copper IUD after the birth of her last child and had it removed two
years ago, hoping to have another child. She has no history of sexually
transmitted infections or abnormal Pap smears. Her cycles are regular
every 28 to 32 days. She is not taking any medications. She has been
married for the last 16 years, and her husband is 52-years-old and in
good health. Her physical examination, including a pelvic exam, is
completely normal. What is the most appropriate next step in the
management of this patient?
A. Perform a hysteroscopy
B. Order a hysterosalpingogram
C. Order clomiphene challenge test
D. Order a sperm penetration assay
E. Basal body temperatures for six months

Answer 1

Based on the search results, the most appropriate next step in the management of this patient who has been unable to conceive for the last two years despite having a normal physical examination is to order a hysterosalpingogram. Therefore, the answer is B.

Step-by-step explanation: