A 41-year-old G2 P1011 presents with a 6 month history of
menometrorrhagia (excessive and irregular menses). Her past
medical history reveals one full term pregnancy conceived by
ovulation induction with insemination three years ago.
Before that pregnancy, her FSH was noted to be 11.8 mIU/ml
on day three of the cycle. One year after the delivery she
reinitiated ovulation induction with gonadotropin and
conceived. Unfortunately, an ectopic pregnancy was diagnosed
and she underwent methotrexate therapy (50mg/m2) which
resolved the ectopic pregnancy. She has continued to attempt
pregnancy but without ovulation
induction because her FSH climbed to 23 mIU/ml on day three.
