A 24 years old female presented with amenorrhea for 3 months. LH and FSH levels are elevated three times the normal value. What is the next best step?
(A) Urinary HCG level (B) Check serum estradiol levels (C) Progesterone challenge test and look for withdrawal bleeding (D) Ultrasound of abdomen and pelvis
(B) Answer- B. Check serum estradiol levelsLH and FSH levels by the third montlt of pregnancy are steady st a low level. HCG takes over tlte function of LH after feilization and inhibils production on LH . Inhibin A produced by fetal trophoblasts suppresses maternal FSH secretion. Hence, 3 times elevation of LH and FSH points towards premature ovariun failure. Serum estradiol levels should be measured to confirm the diognosis