Ovulation

Ovulation

Q. 1

After how many days of ovulation embryo implan­tation occurs ?

 A

3 – 5 days

 B

7 – 9 days

 C

10 – 12 days

 D

13 – 15 days

Q. 1

After how many days of ovulation embryo implan­tation occurs ?

 A

3 – 5 days

 B

7 – 9 days

 C

10 – 12 days

 D

13 – 15 days

Ans. B

Explanation:

7 – 9 days

“From the time a fertilized ovum enters the uterine cavity from the fallopian tube (which occurs 3-4 days after ovulation) until the time ovum implants (7-9 days after ovulation) the uterine secretions called uterinemilk provide nutrition for the early dividing ovum

“At the time of implantation, on days 21-22 of menstrual cycle the predominant morphologic feature is edema of the endometrial stroma.”

Important facts :

  • Oogenesis begins in ovary at 6-8 weeks of gestation.°
  • Maximum number of oocytes (6-7 million) are attained at 20 weeks of gestation.°
  • All the primary oocytes in the ovary of a newborn are arrested In the late prophase (of meiosis) till puberty.°
  • At puberty as a result of mid cycle preovulatory surge, meiosis is resumed and compTetedjust prior to ovulation.°
  • Therefore first polar body is released just prior fo ovulation
  • The second division starts immediately after_ it and is arrested in metaphase.°
  • At the time of fertilization second division is completed which results in the release of oocyte and second polar body.
  • Therefore second polar body release occurs only at the time of fertilisation.°
  • LH surge preceedes ovulation by 34-36 hours.o
  • LH peak preceedes ovulation by 10-16 hours.o
  • Prior to ovulation :- Follicle reaches a size of 18-20mm.

                                    – Endometrium is 9-10 min trick.o

                                    – Endometrium show triple line on USG.o

  • Ovulation occurs 14 days before the next menstruation.°
  • Maximum action of corpus luteum is at 22 day of menstruation° (following which it starts regressing ~ 8 years after ovulation).°
  • In absence of fertilisation and implanation the corpus leteum persists for 12-14 days.o
  • Maximum growth of corpus lutem of pregnancy is at 8th week of gestation and degenerates at 6  months of gestation.o
  • Fertilisation occurs in the ampullary part of fallopian tube.°
  • Fertilised egg enters the uterus on day 18 – 19 of the cycle.°

Q. 2

In a young female ot reproductive age with regular menstrual cycles of 28 days, ovulation occurs around 14th day of periods. When is first polar body extruded ?

 A

24 hours prior to ovulation

 B

Accompanied by ovulation

 C

48 hours atter the ovulation

 D

At ths time of fertilization

Q. 2

In a young female ot reproductive age with regular menstrual cycles of 28 days, ovulation occurs around 14th day of periods. When is first polar body extruded ?

 A

24 hours prior to ovulation

 B

Accompanied by ovulation

 C

48 hours atter the ovulation

 D

At ths time of fertilization

Ans. B

Explanation:

Accompanied by ovulation


Q. 3

In 40 days of menstrual cycle the ovulation occurs at :

 A

14th day

 B

20th day

 C

26th day

 D

30th day

Q. 3

In 40 days of menstrual cycle the ovulation occurs at :

 A

14th day

 B

20th day

 C

26th day

 D

30th day

Ans. C

Explanation:

26th day

  • Ovulation is estimated to occur 14 days before the first day of succeeding cycle and this interval is fixed.
  • In case of irregular cycles, it is the follicular phase which varies, but the luteal phase remains more or less constant at 14 days. therefore day of ovulation can be counted by counting 14 days backward.

As in the question a cycle of 40 days, ovulation will occur 14 days prior to next menstruation i.e. (40-14) = 26 day


Q. 4

Ovulation occurs due to :

 A

Midcycle FSH surge

 B

High prolactin level

 C

Midcycle LH surge

 D

a and c both

Q. 4

Ovulation occurs due to :

 A

Midcycle FSH surge

 B

High prolactin level

 C

Midcycle LH surge

 D

a and c both

Ans. D

Explanation:

a and c both


Q. 5

In a 25 day cycle ovulation occurs on :

 A

14th day

 B

13′h day

 C

11′h day

 D

12′h day

Q. 5

In a 25 day cycle ovulation occurs on :

 A

14th day

 B

13′h day

 C

11′h day

 D

12′h day

Ans. C

Explanation:

11th day


Q. 6

Ovulation in a female with 38 day cycle is :

 A

14th day

 B

8th day

 C

24th day

 D

30th day

Q. 6

Ovulation in a female with 38 day cycle is :

 A

14th day

 B

8th day

 C

24th day

 D

30th day

Ans. C

Explanation:

24th day


Q. 7

Rise in BBT after ovulation is by :

 A

0.5 degree Fahrenheit

 B

1.0 degree Fahrenheit

 C

0.5 degree Celsius

 D

1.0 degree Celsius

Q. 7

Rise in BBT after ovulation is by :

 A

0.5 degree Fahrenheit

 B

1.0 degree Fahrenheit

 C

0.5 degree Celsius

 D

1.0 degree Celsius

Ans. A

Explanation:

Ans:A.)0.5 degree Fahrenheit.

  • Before ovulation, there is only a small amount of progesterone present in your body and your basal body temperatures (your resting temperatures) are in the lower range.
  • After ovulation, when there is increased progesterone secreted from the corpus luteum, temperatures become elevated.
  • The temperature elevation that occurs after ovulation is sufficient to be measured with a BBT thermometer .
  • The rise in temperature is usually about 0.4 degrees Fahrenheit or 0.2 degrees Celsius.

Q. 8

Post ovulation, the cervical mucus :

 A

Shows pattern on drying

 B

Is thick

 C

Is thin and cellular

 D

Is thin and alkaline

Q. 8

Post ovulation, the cervical mucus :

 A

Shows pattern on drying

 B

Is thick

 C

Is thin and cellular

 D

Is thin and alkaline

Ans. B

Explanation:

ls thick


Q. 9

Maximum function of corpus luteum occurs :

 A

At ovulation

 B

Before ovulation

 C

3 days after ovulation

 D

9 days after ovulation

Q. 9

Maximum function of corpus luteum occurs :

 A

At ovulation

 B

Before ovulation

 C

3 days after ovulation

 D

9 days after ovulation

Ans. D

Explanation:

9 days after ovulation


Q. 10

Diagnosis of imminent ovulation is :

 A

Endometrial biopsy

 B

Pain

 C

Temperature chart

 D

LH surge

Q. 10

Diagnosis of imminent ovulation is :

 A

Endometrial biopsy

 B

Pain

 C

Temperature chart

 D

LH surge

Ans. D

Explanation:

LH surge


Q. 11

Ovulation coincides with :

 A

Estrogen surge

 B

Progesterone surge

 C

FSH surge

 D

LH surge

Q. 11

Ovulation coincides with :

 A

Estrogen surge

 B

Progesterone surge

 C

FSH surge

 D

LH surge

Ans. D

Explanation:

LH surge


Q. 12

LH surge preceedes ovulation by :

 A

12 hrs.

 B

24 hrs.

 C

36 hrs.

 D

48 hrs.

Q. 12

LH surge preceedes ovulation by :

 A

12 hrs.

 B

24 hrs.

 C

36 hrs.

 D

48 hrs.

Ans. B

Explanation:

Ans:B.)24 Hours.

OVULATION

  • It is the process by which the oocyte-cumulus is released from the follicle. 
  •  Sustained peak level of estrogen for 24–36 hours in the late follicular phase → LH surge occurs from the anterior pituitary.
  • Ovulation approximately occurs 16–24 hours after the LH surge. LH peak persists for about 24 hours. The LH surge stimulates completion of reduction division of the oocyte and initiates luteinization of the granulosa
  • cells, synthesis of progesterone and prostaglandins.

 


Q. 13

Occurrence of ovulation is indicated by :

 A

Progesterone

 B

LH

 C

Estradiol

 D

All of the above

Q. 13

Occurrence of ovulation is indicated by :

 A

Progesterone

 B

LH

 C

Estradiol

 D

All of the above

Ans. D

Explanation:

All of the above


Q. 14

Time of ovulation is detected by :

 A

Urine LH

 B

Urine FSH

 C

Urine HCG

 D

A and B both

Q. 14

Time of ovulation is detected by :

 A

Urine LH

 B

Urine FSH

 C

Urine HCG

 D

A and B both

Ans. D

Explanation:

A and B both


Q. 15

Best diagnosis of ovulation is by :

 A

Ultrasound

 B

Laproscopy

 C

Endometrial biopsy

 D

Chromotubation

Q. 15

Best diagnosis of ovulation is by :

 A

Ultrasound

 B

Laproscopy

 C

Endometrial biopsy

 D

Chromotubation

Ans. A

Explanation:

Ultrasound


Q. 16

The best predictor of ovulation is :

 A

Estrogen peak

 B

Follicle stimulating hormone (FSH) surge

 C

Onset of the LH surge

 D

Preovulatory rise in progesterone

Q. 16

The best predictor of ovulation is :

 A

Estrogen peak

 B

Follicle stimulating hormone (FSH) surge

 C

Onset of the LH surge

 D

Preovulatory rise in progesterone

Ans. C

Explanation:

Onset of the LH surge


Q. 17

Persistent anovulation not treated leads to all except :

 A

Hirsutism

 B

Ovarian Carcinoma

 C

Endometrial Carcinoma

 D

Increased risk of CVS disease

Q. 17

Persistent anovulation not treated leads to all except :

 A

Hirsutism

 B

Ovarian Carcinoma

 C

Endometrial Carcinoma

 D

Increased risk of CVS disease

Ans. B

Explanation:

  1.   Ans. is b i.e. Ovarian carcinoma  

Clinical Consequences of Persistent Anovulation

  1. Infertility°
  2. Menstrual bleeding problems ranging from amenorrhea to irregular, heavy bleeding° (DUB). Most common menstrual disorder associated with anovulation is oligomenorrhea.°
  3. Hirsutism°, Alopecia° and Acne.
  4. Increased risk of Endometrial cancer° and perhaps, Breast cancer°.
  5. Increased risk of Cardiovascular disease°.
  6. Increased risk of Diabetes mellitus° in patients with insulin resistance.

Extra Edge :

Recommended investigations in case of anovulatory hyperandrogenic women (to exclude specific causes and problems).

1.

Thyroid stimulating hormone

4.

Screen for cushing disease

2.

Prolactin

5.

Endometrial biopsy

3.

Lipid and Lipoprotein profile

6.

Glucose tolerance

 

 

7.

Body mass Index.

In the presence of clinical signs of excess androgen stimulation – Two tests which should be done are :

  1. Total testosterone levels
  2. 17 – hydroxy progesterone morning and fasting.

Q. 18

Persistent untreated anovulation leads to all of the following EXCEPT :

 A

Hirsutism

 B

Increased risk of cardiovascular disease

 C

Increased ovarian tumour

 D

Increased endometrial carcinoma

Q. 18

Persistent untreated anovulation leads to all of the following EXCEPT :

 A

Hirsutism

 B

Increased risk of cardiovascular disease

 C

Increased ovarian tumour

 D

Increased endometrial carcinoma

Ans. C

Explanation:

Increased ovarian tumour


Q. 19

Drugs used for ovulation induction :

 A

Clomiphene citrate

 B

Danazol

 C

Tamoxifen

 D

Option A and C both

Q. 19

Drugs used for ovulation induction :

 A

Clomiphene citrate

 B

Danazol

 C

Tamoxifen

 D

Option A and C both

Ans. D

Explanation:

Ans. is a and c i.e. Clomiphene citrate; and Tamoxifen

Drugs used for

  • Clomiphene                                                                        • Chlorpromazine

(given 50mg daily OD from D2-D5 upto max. 150my/day)                 • Reserpine

  • Tamoxifen                                                                           • Busulfan

(given 10mg BD from Day 2- Day 6 upto max. of 40mg daily)            • Vinca alkaloid

  • Corticosteroid (Cortisone)                                                        • Bleomycin

useful in infertility d/t Congenital, adrenal hyperplasia,                     • Cytosine arabinoside

Addison’s disease                                                                        • Hydroxyurea

  • Dexamethasone                                                                  • Electroconvulsive therapy

In patients of hirsutism (Dexamethasone + clomiphene                   • Estrogens/OCP’s

0.5mg at bed time), given good response                                       • Androgens

  • Gonadotrophins                                                                    • Danazol

useful in cases where ovulation is arrested d/t failure in the production of gonadotrophins by the HPO axis

Available preparation : HMG (has 75U of FSH & LH each) Purified urinary FSH

Recombinant FSH

Recombinant HCG

Recombinant LH

  • GnRH (In cases where anovulation occurs d/t hypothalamic inhibition with anterior pituitary intact), GnRH analogues are used to induce ovulation.
  • Bromocriptine It does not Specifically induce ovulation but is DOC for those women with dysmenorrhea / infertility associated with hyperprolactinemia.

Q. 20

Decreased ovulation / impaired ovulation casued by :

 A

Minipill (prgesterone only pill)

 B

IUCD

 C

Norplant

 D

All

Q. 20

Decreased ovulation / impaired ovulation casued by :

 A

Minipill (prgesterone only pill)

 B

IUCD

 C

Norplant

 D

All

Ans. D

Explanation:

Ans.is D.)All i.e: Minipill (progesterone only pill); IUCD; and Norplant

  • Norplant offers long-term contraception through the use of subdermal capsules filled with levonorgestrel. The six capsules are implanted in the inside part of the upper arm. The levonorgestrel is released from the capsules gradually, providing contraception for about 5 years. The primary mechanism of action of Norplant is suppression of ovulation.
  • IUCDs primarily work by preventing fertilization.The progestogen released from the hormonal IUDs may prevent ovulation from occurring but only partially.The hormone also thickens the cervical mucus so that sperm cannot reach the fallopian tubes. Copper IUDs contain no hormones, but the copper ions in the cervical mucus are toxic to sperm. They also cause the uterus and fallopian tubes to produce a fluid that contains white blood cells, copper ions, enzymes, and prostaglandins, a combination that is also toxic to sperm.
  • Mechanism of Action of Mini pill(Progesterone Containing pill):Progestin-only oral contraceptives – Mechanisms of action include (1) suppression of ovulation; (2) a variable dampening effect on the midcycle peaks of LH and FSH; (3) an increase in cervical mucus viscosity; (4) a reduction in the number and size of endometrial glands; and (5) a reduction in cilia motility in the fallopian tube

Q. 21

Ovulation is associated most commonly with?

 A LH surge
 B

Increase in progesterone

 C Increase in FSH
 D

Increase in basal body temperature

Q. 21

Ovulation is associated most commonly with?

 A LH surge
 B

Increase in progesterone

 C Increase in FSH
 D

Increase in basal body temperature

Ans. A

Explanation:

LH surge REF: Ganong WF: Review of Medical Physiology, 22nd ed (chapter 23) Figure 6-10, William’s obstetrics 22″d edition Figure 3-1.

“The onset of the gonadotropin surge resulting from increasing secretion of estrogen by preovulatory follicles is a relatively precise predictor of the time of ovulation, occurring some 34 to 36 hours before the release of the ovum from the follicle. The peak of LH secretion occurs 10 to 12 hours before ovulation and stimulates the resumption of the meiosis process in the ovum with the release of the first polar body”


Q. 22

Which is not a test for ovulation?

 A Fern test
 B

Basal body temperature

 C Hysteroscopy
 D

LH surge

Q. 22

Which is not a test for ovulation?

 A Fern test
 B

Basal body temperature

 C Hysteroscopy
 D

LH surge

Ans. C

Explanation:

Hysteroscopy REF: 12th edition of Novak’s Gynecology p. 408

METHODS TO DOCUMENT OVULATION:

  • Luteinizing Hormone Monitoring Documentation of the LH surge represents a remarkably reproducible method of predicting ovulation. Ovulation occurs 34 to 36 hours after the onset of the LH surge and about 10 to 12 hours after the LH peak
  • Basal Body Temperature The least expensive method of confirming ovulation is for the
    patient to record her temperature each morning on a basal body temperature (BBT) chart.
  • Midluteal Serum Progesterone
  • Ultrasound Monitoring Ovulation can also be documented by monitoring the development of a dominant follicle by ultrasound until ovulation takes place
  • A ferning pattern is seen when periovulatory cervical mucus is spread and dried on a microscope slide.

Q. 23 Ovulation can be evaluated by? 
 A

Cervical mucous

 B

Cervical colour

 C

Cervical dilation

 D

Cervical effacement

Q. 23 Ovulation can be evaluated by? 
 A

Cervical mucous

 B

Cervical colour

 C

Cervical dilation

 D

Cervical effacement

Ans. A

Explanation:

Cervical mucous

REF: Shaw 13th ed p. 213

“Cervical mucus changes can be used to assess ovulation using the fern test”


Q. 24

After how many days of ovulation embryo implantation occurs ?

 A

3 – 5 days

 B

7 – 9 days

 C

10 – 12 days

 D

13 – 15 days

Q. 24

After how many days of ovulation embryo implantation occurs ?

 A

3 – 5 days

 B

7 – 9 days

 C

10 – 12 days

 D

13 – 15 days

Ans. B

Explanation:

Ans. is b i.e. 7 – 9 days

“From the time a fertilized ovum enters the uterine cavity from the fallopian tube (which occurs 3-4 days after ovulation) until the time ovum implants (7-9 days after ovulation) the uterine secretions called uterine milk provides nutrition for the early dividing ovum.”

“At the time of implantation, on days 21-22 of menstrual cycle the predominant morphologic feature is edema of the endometrial stroma.”

Important facts :

  • Oogenesis begins in ovary at 6-8 weeks of gestation.°
  • Maximum number of oocytes (6-7 million) are attained at ‘in weekF• of gestation.°

All the primary oocytes in the ovary of a newborn are arrested in the late prophase (of meiosis) till puberty.°

  • At puberty as a result of mid cycle preovulatory surge, meiosis is resumed and completed just prior to ovulation.°
  • Therefore first polar body is released just j.-,r,or to °mistier..
  • The second division starts immediately after it and is arrested in metaphase.Q
  • At the time of fertilization second division is completed which results in the release of oocyte and second polar body.
  • Therefore second polar body release occurs only at the time of fertilisation.°

LH surge precedes ovulation by 34-36 hours.°

  • LH peak precedes ovulation by 10-16 hours.°
  • Prior to ovulation : – Follicle reaches a size of 18-20 mm.

–     Endometrium is 9 – 10 mm thick.°

–     Endometrium shows triple line on USG.°

  • Ovulation occurs 14 days before the next menstruation.°
  • Maximum action of corpus luteum is at 22 day of menstruation° (following which it starts regressing – 8 days after ovulation).°
  • In absence of fertilisation and implantation the corpus luteum persists for 12 – 14 days.°
  • Maximum growth of corpus luteum of pregnancy is at 8th week of gestation and degenerates at 6 months of gestation.°
  • Fertilisation occurs in the ampullary part of fallopian tube.°
  • Fertilised egg enters the uterus on day 18 – 19 of the cycle.°



Q. 25

In a young female of reproductive age with regu­lar menstrual cycles of 28 days, ovulation occurs around 14th day of periods. When is the first polar

body extruded ?

 A

24 hrs prior to ovulation

 B

Accompanied by ovulation

 C

48 hrs after the ovulation

 D

At the time of fertilization

Q. 25

In a young female of reproductive age with regu­lar menstrual cycles of 28 days, ovulation occurs around 14th day of periods. When is the first polar

body extruded ?

 A

24 hrs prior to ovulation

 B

Accompanied by ovulation

 C

48 hrs after the ovulation

 D

At the time of fertilization

Ans. B

Explanation:

Ans. is b i.e. Accompanied by ovulation

  • Most of the standard text books say the first polar body is expelled just before or shortly before ovulation.
  • Which does not mean that it is released 24 hours before ovulation.
  • ‘While still in the ovary the ovum is in rile primary oocyte stage. Shortly before it is released from ovarian follicle (i.e. shortly before ovulation), its nucleus divides by meiosis and a first polar body is expelled from the nucleus of the oocyte. The primary oocyte then becomes the secondary oocyte. In this process each of the 23 unpaired of chromosomes loses one of its partners which become the first polar body that is expelled. This leaves 23 unpaired chromosomes in the secondary oocyte. It is at this time that the ovum, still in the secondary oocyte stage is ovulated into the abdominal cavity.”
  • So, first polar body is released at the time of ovulation i.e. Option “b

Note :    • The secondary oocyte immediately begins the second meiotic division, but this division stops at metaphase and is completed only when sperm penetrates the oocyte.

  • At this time second polar body is cast off. So second polar body is cast off at the time of fertilization.

Extra Edge

  • Friends this is an often repeated question and those who find it difficult to remember this basic fact : I have a mnemonic :
  • Mnemonic
  • PP1 and M2F
  • PP1 i.e. 1st meiotic division is arrested in Prophase and completed just prior to ovulation releasing the 1st polar body.
  • M2F : i.e. 2nd meiotic division is arrested in metaphase and completed at the time of fertilisation releasing the 2nd polar body.

Q. 26

How many days after ovulation is placental circulation established :

 A

18-21

 B

9-11

 C

7-9

 D

30-33

Q. 26

How many days after ovulation is placental circulation established :

 A

18-21

 B

9-11

 C

7-9

 D

30-33

Ans. A

Explanation:

18-21


Q. 27

Ovulation coincides with:

 A

High estrogen & high progesterone

 B

LH surge

 C

Low estrogen & high progesterone

 D

Progesterone peak

Q. 27

Ovulation coincides with:

 A

High estrogen & high progesterone

 B

LH surge

 C

Low estrogen & high progesterone

 D

Progesterone peak

Ans. B

Explanation:

LH surge


Q. 28

How many hours prior to ovulation does LH Surge occur?

 A

6-8 hrs

 B

10-16 hrs

 C

18-24 hrs

 D

More than 24 hrs

Q. 28

How many hours prior to ovulation does LH Surge occur?

 A

6-8 hrs

 B

10-16 hrs

 C

18-24 hrs

 D

More than 24 hrs

Ans. C

Explanation:

Ans:C.)18-24 hours.

Sustained peak level of estrogen for 24–36 hours in the late follicular phase → LH surge occurs from the anterior pituitary.

Ovulation approximately occurs 16–24 hours after the LH surge.

LH peak persists for about 24 hours.

The LH surge stimulates completion of reduction division of the oocyte and initiates luteinization of the granulosa cells, synthesis of progesterone and prostaglandins.

Ref: Dutta


Q. 29

How many days approximately the corpus luteum of menstruation persists after ovulation?

 A

5 days

 B

10 days

 C

14 days

 D

30 days

Q. 29

How many days approximately the corpus luteum of menstruation persists after ovulation?

 A

5 days

 B

10 days

 C

14 days

 D

30 days

Ans. B

Explanation:

The fate of the corpus luteum depends on whether a pregnancy occurs.

Following the LH surge, the corpus luteum is programmed to secrete progesterone for 10–12 days.

Without further LH stimulation and in the absence of pregnancy, both major cell types of the corpus luteum cease steroid production and undergo apoptosis while the tissue regresses. The corpus luteum that persists for part of only one menstrual cycle is called a corpus luteum of menstruation.

Remnants from its degeneration and regression are phagocytosed by macrophages, after which fibroblasts invade the area and produce a scar of dense connective tissue called corpus albicans. 
Ref: Mescher A.L. (2010). Chapter 22. The Female Reproductive System. In A.L. Mescher (Ed), Junqueira’s Basic Histology: Text & Atlas, 12e.

Q. 30

The time duration for functioning of corpus luteum after ovulation in a nonpregnant female is:

 A

5 days

 B

10 days

 C

14 days

 D

30 days

Q. 30

The time duration for functioning of corpus luteum after ovulation in a nonpregnant female is:

 A

5 days

 B

10 days

 C

14 days

 D

30 days

Ans. B

Explanation:

Following ovulation, the corpus luteum develops from the remains of the dominant or Graafian follicle in a process referred to as luteinization. The human corpus luteum is a transient endocrine organ that, in the absence of pregnancy, will rapidly regress 9 to 11 days after ovulation.

Luteolysis results from decreased levels of circulating LH in the late luteal phase and decreased LH sensitivity of luteal cells. Luteolysis is characterized by a loss of luteal cells by apoptotic cell death.

 
Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 3. Implantation, Embryogenesis, and Placental Development. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e.

 


Q. 31

Which among the following is the best diagnostic method for finding out ovulation?

 A

Ultrasound

 B

Laparoscopy

 C

Endometrial biopsy

 D

Chromotubation

Q. 31

Which among the following is the best diagnostic method for finding out ovulation?

 A

Ultrasound

 B

Laparoscopy

 C

Endometrial biopsy

 D

Chromotubation

Ans. C

Explanation:

The finding of secretory endometrium confirms ovulation.

The use of an endometrial biopsy (EMB) near the end of the luteal phase can provide reassurance of an adequate maturational effect on the endometrial lining.

Within 48 hours of ovulation, the cervical mucus changes under the influence of progesterone to become thick, tacky, and cellular, with loss of the crystalline fernlike pattern on drying.

 
Ref: Ghadir S., Ambartsumyan G., DeCherney A.H. (2013). Chapter 53. Infertility. In A.H. DeCherney, L. Nathan, N. Laufer, A.S. Roman (Eds), CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e.

 


Q. 32

What is the approximate duration between LH surge and ovulation?

 A

18-20 hours

 B

48-50 hours

 C

34-36 hours

 D

12-18 hours

Q. 32

What is the approximate duration between LH surge and ovulation?

 A

18-20 hours

 B

48-50 hours

 C

34-36 hours

 D

12-18 hours

Ans. C

Explanation:

The onset of the gonadotropin surge resulting from increasing estrogen secretion by preovulatory follicles is a relatively precise predictor of ovulation.
It occurs 34 to 36 hours before release of the ovum from the follicle.
LH secretion peaks 10 to 12 hours before ovulation and stimulates the resumption of meiosis in the ovum with the release of the first polar body.
 
Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 3. Implantation, Embryogenesis, and Placental Development. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e.

Q. 33

Which of the following methods for assessment of female fertility during a menstrual cycle can best predict the timing of ovulation?

 A

Basal Body Temperature (BBT)

 B

Fern Test

 C

Spinnbarkeit phenomenon

 D

Hormonal study

Q. 33

Which of the following methods for assessment of female fertility during a menstrual cycle can best predict the timing of ovulation?

 A

Basal Body Temperature (BBT)

 B

Fern Test

 C

Spinnbarkeit phenomenon

 D

Hormonal study

Ans. D

Explanation:

The best method of assessment of female fertility that allows accurate prediction of ovulation is the measurement of urinary LH surge (Hormonal Test).

 
Ref: Clinical Gynaecological Endocrinology and Infertility By Speroff, 7th Edition, Page 1036; Textbook of Gynecology By DC Dutta, 4th Edition, Page 106 221; Management of Common Problems in Obstetrics and Gynecology By T. Murphy Goodwin, Martin 4. N. Montoro, Laila Muderspach, Subir Roy, 5th Edition, Page 430

 


Q. 34

Which is NOT a documentation test for ovulation in women of reproductive age?

 A

Fern test

 B

Basal body temperature

 C

Hysteroscopy

 D

LH surge

Q. 34

Which is NOT a documentation test for ovulation in women of reproductive age?

 A

Fern test

 B

Basal body temperature

 C

Hysteroscopy

 D

LH surge

Ans. C

Explanation:

Methods to document ovulation:

  • Luteinizing Hormone Monitoring Documentation of the LH surge represents a remarkable reproducible method of predicting ovulation. Ovulation occurs 34 to 36 hours after the onsof the LH surge and about 10 to 12 hours after the LH peak.
  • Basal Body Temperature
  • Midluteal Serum Progesterone
  • Ultrasound Monitoring Ovulation
  • A ferning pattern is seen when periovulatory cervical mucus is spread and dried on a microscope slide.

Q. 35

Which of the following drug is an antihormonal substance used to induce ovulation?

 A

Raloxifen

 B

Tamoxifen

 C

Mefiprestone

 D

Clomiphene citrate

Q. 35

Which of the following drug is an antihormonal substance used to induce ovulation?

 A

Raloxifen

 B

Tamoxifen

 C

Mefiprestone

 D

Clomiphene citrate

Ans. D

Explanation:

Clomiphene citrate is a nonsteroidal estrogen antagonist that increases FSH and LH levels by blocking estrogen negative feedback at the hypothalamus.

Clomiphene citrate is approved by the FDA, as an ovulation-inducing drug. It is given orally in dosages of 50 to 100 mg/d for 5 days on a monthly basis to induce ovulation in infertile women.

Ref: Textbook of gynecology by D C Dutta 4th Edition, Page 486-7.


Q. 36

One of your patient who was diagnosed to have hypogonadism was found to have normal FSH and oestradiol levels. This patient belongs to which type as per the WHO classification of disorders of ovulation?

 A

Type I

 B

Type II

 C

Type III

 D

Type IV

Q. 36

One of your patient who was diagnosed to have hypogonadism was found to have normal FSH and oestradiol levels. This patient belongs to which type as per the WHO classification of disorders of ovulation?

 A

Type I

 B

Type II

 C

Type III

 D

Type IV

Ans. B

Explanation:

WHO classification of disorder of ovulation is given below Type I – Hypogonadotropic hypogonadism, low FSH and LH, low oestradiol Type II – Normogonadotropic hypogonadism, normal FSH, normal oestradiol Type III – Hypergonadotropic hypogonadism, high FSH and LH, low oestradiol

Ref: Essentials of Gynaecology by Lakshmi Seshadri, Edition 1, page – 274.


Q. 37

Ovulation can be evaluated by changes in which of the following?

 A

Cervical mucous

 B

Cervical colour

 C

Cervical dilation

 D

Cervical effacement

Q. 37

Ovulation can be evaluated by changes in which of the following?

 A

Cervical mucous

 B

Cervical colour

 C

Cervical dilation

 D

Cervical effacement

Ans. A

Explanation:

Within 48 hours of ovulation, the cervical mucus changes under the influence of progesterone to become thicker, tacky, and cellular, with loss of crystalline fern pattern on drying.

Other methods to test the ovulation are, 

  • Basal body temperature monitoring to assess the rise in temperature
  • Endometrial biopsy to look for secretory changes
  • Ultrasonic visualization of the collapse of mature follicle with free fluid in pouch of Douglas
  • Ultrasonic assessment of the endometrial thickness, pattern, volume and blood flow
  • Serum progesterone on day 21 of period 
  • LH surge detection in serum or urine

Ref: Textbook of Gynecology By Sudha Salhan, 2012, Page 132 ; Shaw, 13th ed, Page 213 ; A Comprehensive Textbook of Obstetrics and Gynecology By Sadhana Gupta, 2011, Page 227


Q. 38

Microscopical appearance of cervical mucus after ovulation is:

 A

Shows pattern on drying

 B

Is thick

 C

Is thin and cellular

 D

Is thin and alkaline

Q. 38

Microscopical appearance of cervical mucus after ovulation is:

 A

Shows pattern on drying

 B

Is thick

 C

Is thin and cellular

 D

Is thin and alkaline

Ans. B

Explanation:

The fern test can determine the presence or absence of ovulation or the time of ovulation.

When cervical mucus is spread on a clean, dry slide and allowed to dry in air, it may or may not assume a frondlike pattern when viewed under the microscope.

The fern frond pattern indicates an estrogenic effect on the mucus without the influence of progesterone; thus, a non-frondlike pattern can be interpreted as showing that ovulation has occurred.

Progesterone makes the mucus thick and cellular.
 
Ref: Kawada C., Hochner-Celnikier D. (2013). Chapter 35. Gynecologic History, Examination, & Diagnostic Procedures. In A.H. DeCherney, L. Nathan, N. Laufer, A.S. Roman (Eds), CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e.

Q. 39

Watery nature of the cervical mucus at the time of ovulation may be caused by:

 A

Oestrogen

 B

Progesterone

 C

Infection

 D

All of the above

Q. 39

Watery nature of the cervical mucus at the time of ovulation may be caused by:

 A

Oestrogen

 B

Progesterone

 C

Infection

 D

All of the above

Ans. A

Explanation:

Estrogen makes the mucus much thinner and more alkaline, changes that promote the survival and transport of sperm.

Progesterone makes it thick, tenacious, and cellular.

The mucus is thinnest at the time of ovulation, and its elasticity, or spinnbarkeit, increases so that by midcycle a drop can be stretched into a long, thin thread that may be 8–12 cm or more in length.

 
Ref: Alford C., Nurudeen S. (2013). Chapter 4. Physiology of Reproduction in Women. In A.H. DeCherney, L. Nathan, N. Laufer, A.S. Roman (Eds),CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e.

Q. 40

Which of the following hormonal activity is expected immediately prior to Ovulation?

 A

LH surge

 B

FSH surge

 C

Progestrone surge

 D

Estrogen surge

Q. 40

Which of the following hormonal activity is expected immediately prior to Ovulation?

 A

LH surge

 B

FSH surge

 C

Progestrone surge

 D

Estrogen surge

Ans. A

Explanation:

Ovulation occurs due to the effect of increased concentration of LH. In the pre-ovulatory phase of the menstrual cycle, the ovarian follicle will undergo a series of transformations called cumulus expansion, which is stimulated by FSH. This is followed by LH surge.


Q. 41

In a 29 day menstrual cycle ovulation takes place at:

 A

14th day

 B

15th day

 C

16th day

 D

17th day

Q. 41

In a 29 day menstrual cycle ovulation takes place at:

 A

14th day

 B

15th day

 C

16th day

 D

17th day

Ans. B

Explanation:

If the menstrual cycle is 29 days long, ovulation takes place on 15th day. Date of ovulation is calculated by substracting 14 days from the duration of menstrual cycle.

A surge in LH secretion triggers ovulation, and ovulation normally occurs about 9 hours after the  peak of the LH surge at midcycle. The follicle that ruptures at the time of ovulation fills with blood and is called corpus hemorrhagicum. The granulosa and theca cells lining the follicle begin to proliferate and gets filled with yellowish lipid rich luteal cells forming the corpus luteum.

Ref: Ganong’s Review of Medical Physiology, 24e, chapter 22

 


Q. 42

Ovulation is primarily caused by preovulatory surge of:

 A

Estradiol

 B

Luteinizing hormone

 C

Progesterone

 D

Follicle stimulating hormone

Q. 42

Ovulation is primarily caused by preovulatory surge of:

 A

Estradiol

 B

Luteinizing hormone

 C

Progesterone

 D

Follicle stimulating hormone

Ans. B

Explanation:

A surge in LH secretion triggers ovulation and ovulation normally occurs about 9 hours after the peak of the LH surge at midcycle. 

Ref: Ganong’s Review of Medical Physiology, 22nd Edition, Page 438; Reproductive Endocrinology: A Molecular Approach By Pedro J. Chedrese, 2009, Page 299.

Q. 43

A fertilised ovum reaches the uterine cavity by the 7th day from ovulation. How long does it take for it to travel through the fallopian tube?

 A

3-4 days

 B

5-6 days

 C

7-8 days

 D

10 days

Q. 43

A fertilised ovum reaches the uterine cavity by the 7th day from ovulation. How long does it take for it to travel through the fallopian tube?

 A

3-4 days

 B

5-6 days

 C

7-8 days

 D

10 days

Ans. A

Explanation:

The fertilised ovum takes 3-4 days to travel through the fallopian tube and reaches the uterine cavity by the 7th day from ovulation. It is fully embedded in the endometrium by the 14th day.


Q. 44

Ovulation is associated with sudden rise in the level of which of the following hormone?

 A

Prolactin

 B

Testosterone

 C

LH

 D

Oxytocin

Q. 44

Ovulation is associated with sudden rise in the level of which of the following hormone?

 A

Prolactin

 B

Testosterone

 C

LH

 D

Oxytocin

Ans. C

Explanation:

Ovulation is the process by which the oocyte-cumulus is released from the follicle. Towards the end of follicular phase the levels of estradiol increases dramatically and exerts a positive feedback at both hypothalamus and anterior pituitary causing LH surge. LH surge last for 48 hours and ovulation occurs approximately 36 to 40 hours after the onset of LH surge.
 
The LH surge:
Acts rapidly on both the granulosa and theca cells of the preovulatory follicle and turn on the expression of genes required for ovulation and luteinization.
It also initiates the re entry of the oocyte into meiosis, expansion of the cumulus oophorus, synthesis of prostaglandins, and luteinization of granulosa cells.
 
Ref: Williams Gynecology, 2e chapter 15.

Q. 45

In a young female of reproductive age with regular menstrual cycles of 28 days ovulation occurs around 14th day of periods. When is the first polar body extruded

 A

24 hrs prior to ovulation

 B

Accompanied by ovulation

 C

48 hrs after the ovulation

 D

At the time of fertilization

Q. 45

In a young female of reproductive age with regular menstrual cycles of 28 days ovulation occurs around 14th day of periods. When is the first polar body extruded

 A

24 hrs prior to ovulation

 B

Accompanied by ovulation

 C

48 hrs after the ovulation

 D

At the time of fertilization

Ans. A

Explanation:

A i.e. 24 hours prior to ovulation

Event In Oogenesis

Time period

Maximum number of germ cell (Oogonia & few oocyte) – 7 million are found by

5th month (prenatal)

All oogonia become atretic and only primary oocyte surrounded by follicular cell (k/a primordial

follicle) remain by

7″, month (prenatal)

All primary oocyte have started prophase of meiosis I, but instead of proceeding into metaphase,

they enter diplotene stage

Near the time of birth

Primary oocyte remain in prophase of meiosis I until

Puberty

Primordial follicle (with primary oocyte) grow to form primary/ preantral- follicle, which grows into

secondary / vesicular / Graffian- follicle. The 2° follicle enters preovulatory stage – 36 hours before

ovulation (when LH surge occurs) resulting in completion of meiosis I and formation of

secondary oocyte and 1st polar bodyQ

36 hours before ovulation

2° oocyte enters meiosis 11 but arrests in metaphase

– 3 hours before ovulation

Meiosis II is completed with formation of ovulin and 2″ polar body only if

Fertilization occurs

Without fertilization 2° oocyte degenerates with in

24 hours after ovulation


Q. 46

Ovulation is associated with sudden rise in:

 A

Prolactin

 B

Testosterone

 C

LH

 D

Oxytocin

Q. 46

Ovulation is associated with sudden rise in:

 A

Prolactin

 B

Testosterone

 C

LH

 D

Oxytocin

Ans. C

Explanation:

C i.e. LH


Q. 47

Ovulation corresponds with:

 A

FSH surge

 B

LH surge

 C

Progesterone surge

 D

Estradiol surge

Q. 47

Ovulation corresponds with:

 A

FSH surge

 B

LH surge

 C

Progesterone surge

 D

Estradiol surge

Ans. B

Explanation:

B i.e. LH surge

A surge in LH secretion triggers ovulationQ, and ovulation normally occurs about 9 hours after the peak of LH surge at midcycle.


Q. 48

Ovulation is primarily caused by preovulatory surge of:

 A

Estradiol

 B

Luteinizing hormone

 C

Progesterone

 D

Follicle stimulating hormone

Q. 48

Ovulation is primarily caused by preovulatory surge of:

 A

Estradiol

 B

Luteinizing hormone

 C

Progesterone

 D

Follicle stimulating hormone

Ans. B

Explanation:

B i.e. LH

A surge in LH secretion triggers ovulation and ovulation normally occurs about 9 hours after the peak of the LH surge at midcycle’Q


Q. 49

There is a mid-cycle shift in the basal body temperature (BBT) after ovulation in women. This is caused by :

 A

FSH-peak

 B

LH-peak

 C

Oestradiol

 D

Progesterone

Q. 49

There is a mid-cycle shift in the basal body temperature (BBT) after ovulation in women. This is caused by :

 A

FSH-peak

 B

LH-peak

 C

Oestradiol

 D

Progesterone

Ans. D

Explanation:

D i.e. Progesterone

Progesterone is thermogenic & responsible for the rise in basal body temperatureQ at the time of ovulation

  • Increase in basal body temperature at the time ovulation in reliable indicator of time of ovulation The rise starts 1-2 days after ovulation
  • Other indicators of ovulation

Secretory patternQ on biopsy of endometrium

Thick cervical mucus that forms a fern pattern


Q. 50

Oral contraceptive pills act mainly by ‑

 A

Production of cervical mucus hostile to sperm penetration

 B

Inhibition of ovulation

 C

Making endometrium unsuitable for implantation

 D

Enhancing uterine contraction to dislodge the fertilized ovum

Q. 50

Oral contraceptive pills act mainly by ‑

 A

Production of cervical mucus hostile to sperm penetration

 B

Inhibition of ovulation

 C

Making endometrium unsuitable for implantation

 D

Enhancing uterine contraction to dislodge the fertilized ovum

Ans. B

Explanation:

Ans. is ‘b’ i.e., Inhibition of ovulation

Mechanism of action of OCPs

Inihibition of gonadotropin release from pitutary by reinforcement of normal feedback inhibition —> No prevulatory LH surge —> No ovulation

This is the most important mechanism.

  1. Thickening of cervical mucus secretion (due to progesterone)       hostile to sperm penetration.
  2. Even if ovulation and fertilization occur, the blastocyte fails to implant because endometrium is either hyperproliferative or hypersecretory – not suitable for nidation                                          
  3. Important in case of postcoital pill.
  4. Uterine and tubal contractions may be modified to disfavour fertilization.
  5. Postcoital pills may dislodge a just implated blastocyte or may interfere fertilization/implantation.

Q. 51

Ovulation is due to surge of:      

September 2006, 2010

 A

FSH

 B

LH

 C

Prolactin

 D

TSH

Q. 51

Ovulation is due to surge of:      

September 2006, 2010

 A

FSH

 B

LH

 C

Prolactin

 D

TSH

Ans. B

Explanation:

Ans. B: LH


Q. 52

Separation of first polar body occurs at the time of:

September 2007, March 2012

 A

Fertilization

 B

Ovulation

 C

Implantation

 D

Menstruation

Q. 52

Separation of first polar body occurs at the time of:

September 2007, March 2012

 A

Fertilization

 B

Ovulation

 C

Implantation

 D

Menstruation

Ans. B

Explanation:

Ans. B: Ovulation

Asymmetrical cell division (cytokinesis) leads to the production of polar bodies during oogenesis. To conserve nutrients, the majority of cytoplasm is segregated into either the secondary oocyte and, or ovum, during meiosis I or meiosis II, respectively.

The remaining daughter cells generated from the meiotic events contain relatively little cytoplasm and are referred to as polar bodies. Eventually, the polar bodies degenerate.

There may be one or two polar bodies in the ovum. The first polar body is one of the two products in the first stage of meiosis, just before ovulation and is considered diploid, with 23 duplicated chromosomes. The second polar body is haploid, with 23 unduplicated chromosomes and is produced only when a sperm penetrates the oocyte.


Q. 53

All of the following are indicators of ovulation except:

March 2008

 A

Increase in cervical mucus

 B

Abdominal cramps

 C

LH surge

 D

Fall in body temperature

Q. 53

All of the following are indicators of ovulation except:

March 2008

 A

Increase in cervical mucus

 B

Abdominal cramps

 C

LH surge

 D

Fall in body temperature

Ans. D

Explanation:

Ans. D: Fall in body temperature

Frequent physical signs indicating ovulation are:

  • Increased body temperature
  • LH surge
  • Increased cervical mucus -cervical mucus is most abundant and becomes clear and slippery and stretches like egg white
  • Change of position and firmness of cervix
  • Abdominal cramps (Mittelschmerz)
  • Increased libido
  • Tender breasts

Q. 54

Ovulation occurs:  

September 2005

 A

14 days after menstruation

 B

14 days prior to next menstruation

 C

On 14th day of the cycle

 D

None of the above

Q. 54

Ovulation occurs:  

September 2005

 A

14 days after menstruation

 B

14 days prior to next menstruation

 C

On 14th day of the cycle

 D

None of the above

Ans. B

Explanation:

Ans. B: 14 days prior to next menstruation

The process of ovulation is controlled by the hypothalamus of the brain and through the release of hormones secreted in the anterior lobe of the pituitary gland, LH and FSH.

In the follicular (pre-ovulatory) phase of the menstrual cycle, the ovarian follicle will undergo a series of transformations called cumulus expansion, this is stimulated by the secretion of FSH. After this is done, a hole called the stigma will form in the follicle, and the ovum will leave the follicle through this hole.

Ovulation is triggered by a spike in the amount of FSH and LH released from the pituitary gland. During the luteal (post­ovulatory) phase, the ovum will travel through the fallopian tube toward the uterus.

If fertilized by a sperm, it may perform implantation there 6-12 days later.

In humans, the few days near ovulation constitute the fertile phase.

The average time of ovulation is the fourteenth day of an average length (twenty-eight day) menstrual cycle.

It is normal for the day of ovulation to vary from the average, with ovulation anywhere between the tenth and nineteenth day being common, but commonly occurs 14 days before the next cycle.

Cycle length alone is not a reliable indicator of the day of ovulation.


Q. 55

Ovulation following delivery, in a non-lactating mother, may occur earliest at:  

September 2011

 A

3 weeks

 B

4 weeks

 C

5 weeks

 D

10 weeks

Q. 55

Ovulation following delivery, in a non-lactating mother, may occur earliest at:  

September 2011

 A

3 weeks

 B

4 weeks

 C

5 weeks

 D

10 weeks

Ans. B

Explanation:

Ans. B: 4 weeks

In non-lactating mothers, ovulation may occur as early as 4 weeks and in lactating mothers about 10 weeks after delivery


Q. 56

Time of ovulation is detected by all EXCEPT:

September 2012

 A

Urine LH

 B

Urine FSH

 C

Serum progesterone

 D

Basal body temperature

Q. 56

Time of ovulation is detected by all EXCEPT:

September 2012

 A

Urine LH

 B

Urine FSH

 C

Serum progesterone

 D

Basal body temperature

Ans. B

Explanation:

Ans. B i.e. Urine FSH

Physiology

  • Best predictor of ovulation: Pre-ovulatory rise in LH
  • In normal menstrual cycle, progesterone is secreted by: Corpus luteum
  • Inhibin is secreted by: Graffian follicle
  • LH precedes ovulation by: 24 hours (Ovulation coincides with LH surge)
  • Ovulatory period: Corresponds to 14 days before next menstruation
  • FSH stimulates: Growth of granulosa cells (measure of ovarian reserve)
  • LH stimulates: Follicle rupture and ovulation.

Q. 57

All of the following assist in predicting ovulation except:

 A

Basal body temperature

 B

Cervical mucus

 C

Serum progesterone in follicular phase

 D

Endometrial biopsy

Q. 57

All of the following assist in predicting ovulation except:

 A

Basal body temperature

 B

Cervical mucus

 C

Serum progesterone in follicular phase

 D

Endometrial biopsy

Ans. C

Explanation:

Ans. C: Serum progesterone in follicular phase

Ovulation is estimated to occurl4 days before the first day of the succeeding cycle, and this interval is more or les fixed. In case of irregular cycles, it is the follicular phase which varies, but the luteal phase remains more or less constant at 14 days

Test of ovulation include 1) basal body temperature, 2) endometrial biopsy, 3) fern test (cervical mucus), 4) ultrasound and 5) hormonal study (progesterone, LH, FSH etc.)

Progesterone level reaches peak of 15 mg/ ml at mid-luteal phase and then declines as the corpus luteum degenerates

Ovulation:

  • Ovulation corresponds to: LH surge
  • LH surge preceeds ovulation by: 24 hours
  • Ovulatory period corresponds to: 14 days before menstruation
  • Best predictor of ovulation: Preovulatory rise in progesterone
  • Corpus luteum is the source of progesterone in normal menstrual cycle
  • Inhibin is secreted by: Graffian follicle

Q. 58

Corpus leuteum starts regressing after how many days of ovulation ‑

 A

5 days

 B

10 days

 C

24 days

 D

None

Q. 58

Corpus leuteum starts regressing after how many days of ovulation ‑

 A

5 days

 B

10 days

 C

24 days

 D

None

Ans. B

Explanation:

Ans. is ‘b’ i.e., 10 days

If ovum is not fertilized, the corpus luteum starts degenerating around day 24 of cycle (about 10 days after ovulation) and is eventually is replaced by fibrous tissue, forming corpus albicans.

Degeneration of corpus luteum is due to decline in level of LH (which is required for maintenance of corpus luteum) and increase in secretion of inhibin by luteal cell itself.


Q. 59

Fertilization takes place after how much time of ovulation ‑

 A

1-2 days

 B

5-6 days

 C

8-12 days

 D

> 12 days

Q. 59

Fertilization takes place after how much time of ovulation ‑

 A

1-2 days

 B

5-6 days

 C

8-12 days

 D

> 12 days

Ans. A

Explanation:

Ans. is ‘a’ i.e., 1-2 days


Q. 60

Implantation occurs after how many days of ovulation ‑

 A

3-4

 B

5-7

 C

10-15

 D

15-20

Q. 60

Implantation occurs after how many days of ovulation ‑

 A

3-4

 B

5-7

 C

10-15

 D

15-20

Ans. B

Explanation:

Ans. is ‘b’ i.e., 5-7


Q. 61

Implantation occurs after how many days of ovulation ‑

 A

2-3

 B

5-7

 C

10-12

 D

>15

Q. 61

Implantation occurs after how many days of ovulation ‑

 A

2-3

 B

5-7

 C

10-12

 D

>15

Ans. B

Explanation:

Ans. is ‘b’ i.e., 5-7


Q. 62

In oogenesis, first meiotic division completes ‑

 A

After ovulation

 B

Before ovulation

 C

During ovulation

 D

At fertilization

Q. 62

In oogenesis, first meiotic division completes ‑

 A

After ovulation

 B

Before ovulation

 C

During ovulation

 D

At fertilization

Ans. B

Explanation:

Ans. is ‘b’ i.e., Before ovulation


Q. 63

LH peak occurs how many hours before ovulation ‑

 A

36-48 hrs.

 B

12-24 hrs.

 C

48-72 hrs.

 D

72-96 hrs.

Q. 63

LH peak occurs how many hours before ovulation ‑

 A

36-48 hrs.

 B

12-24 hrs.

 C

48-72 hrs.

 D

72-96 hrs.

Ans. A

Explanation:

Ans.B.)12-24 hours

Ovulation occurs 34 to 36 hours after the onset of the LH surge and about 10 to 12 hours after the LH peak.




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