Free NCC Reproductive Health and Infertility Examination Practice Questions

Sample Practice Questions

Try these 10 sample questions from the NCC Reproductive Health and Infertility Examination practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1At an initial infertility visit, a patient reports pain with intercourse and difficulty completing vaginal intercourse. Which history domain most directly addresses this potential barrier to conception?

   1. A.Sexual function and intercourse-related symptomsCorrect answer: A
   2. B.Menstrual frequency and duration of bleeding
   3. C.Family history of inherited chromosomal disorders
   4. D.Previous pregnancy and delivery complications

   Explanation: The source states, "You may be asked if you or your partner experience(s) any pain or difficulty with sexual intercourse (such as difficulty with developing/maintaining an erection or with ejaculation) as these issues may interfere with your natural ability to conceive.". Pain and inability to complete intercourse warrant a focused sexual-function history; the other domains remain relevant to infertility but do not characterize the reported barrier.

   Reference: ASRM Infertility: An Overview — The Initial Visit

2. 2A patient with amenorrhea has high FSH and low estradiol. Which source of dysfunction does this pattern favor?

   1. A.Hypothalamic amenorrhea
   2. B.An isolated uterine cavity lesion
   3. C.An isolated cervical stenosis
   4. D.Ovarian insufficiencyCorrect answer: D

   Explanation: The source states, "ovarian insufficiency (high FSH, low estradiol)". High FSH with low estradiol favors ovarian insufficiency. Hypothalamic amenorrhea instead has low or normal FSH with low estradiol, and isolated structural lesions do not produce this ovarian endocrine pattern.

   Reference: ASRM Fertility Evaluation of Infertile Women — Hormonal Testing, p.1258

3. 3During smoking-cessation counseling, a woman asks about smoking and reproductive aging. Compared with nonsmokers, menopause in smokers has been observed to occur, on average, at which interval in the cited ASRM opinion?

   1. A.Eight to ten years earlier
   2. B.Eight to ten years later
   3. C.One to four years earlierCorrect answer: C
   4. D.One to four years later

   Explanation: ASRM states, "The observation that menopause occurs, on average, 1 to 4 years earlier in smoking than in nonsmoking women suggests that smoking may accelerate the rate of follicular depletion". The observed interval is one to four years earlier; the other directions or intervals do not match that finding. This is a population observation, not a prediction for an individual.

   Reference: ASRM Optimizing Natural Fertility — p.57, Smoking

4. 4A patient is scheduled for oocyte retrieval after an hCG trigger in a conventional IVF protocol. Which interval is the usual timing described in the cited ASRM booklet?

   1. A.About 8 to 14 hours after the trigger
   2. B.About 60 to 72 hours after the trigger
   3. C.About 5 to 7 days after the trigger
   4. D.About 34 to 36 hours after the triggerCorrect answer: D

   Explanation: ASRM states, "The eggs are retrieved before ovulation occurs, usually 34 to 36 hours after the hCG injection is given.". Retrieval is timed before ovulation after final maturation; the shorter and later alternatives do not match this protocol interval.

   Reference: ASRM Assisted Reproductive Technologies — Ovarian Stimulation

5. 5A patient has symptomatic hyperprolactinemia caused by a prolactinoma. Which medication is commonly used to lower prolactin?

   1. A.Letrozole
   2. B.Clomiphene citrate
   3. C.Leuprolide
   4. D.CabergolineCorrect answer: D

   Explanation: The source states, "The most commonly used medicines are cabergoline and bromocriptine.". Cabergoline is a prolactin-lowering treatment. Letrozole inhibits aromatase, clomiphene is used for ovulation induction and leuprolide is a GnRH agonist.

   Reference: ASRM Hyperprolactinemia — Medicines Used to Treat Hyperprolactinemia

6. 6A patient planning pregnancy takes prescription medication. Which risk is the preconception medication-safety review intended to identify?

   1. A.Oocyte aneuploidy
   2. B.Recessive carrier status
   3. C.Teratogenic exposureCorrect answer: C
   4. D.Tubal occlusion

   Explanation: The source states, "You should speak with your health-care provider about which medications may be unsafe in pregnancy and may require adjustments.". The review identifies medication exposures that may be unsafe during pregnancy. The other risks require anatomical, chromosomal or inherited-risk assessments rather than being established by the medication review.

   Reference: ASRM Infertility: An Overview — The Initial Visit

7. 7An infertility patient has oligomenorrhea and galactorrhea. Which additional endocrine measurement is specifically indicated by these findings?

   1. A.Serum progesterone alone
   2. B.Serum anti-Müllerian hormone
   3. C.Serum prolactinCorrect answer: C
   4. D.Serum inhibin B

   Explanation: The source states, "Prolactin is not recommended as part of the routine infertility evaluation, but is indicated in the setting of galactorrhea, oligomenorrhea, or amenorrhea.". Galactorrhea with menstrual disturbance is an indication to measure prolactin. Reserve markers and progesterone do not assess the suspected prolactin disorder.

   Reference: ASRM Fertility Evaluation of Infertile Women — Hormonal Testing, p.1258

8. 8An overweight patient with PCOS starts a sustainable weight-loss program. Which hormone group may decrease along with improvement in metabolic health?

   1. A.Gonadotropin-releasing hormone
   2. B.AndrogensCorrect answer: B
   3. C.Thyroid hormones
   4. D.Prolactin

   Explanation: ASRM states, "Losing weight lowers the risk of diabetes and androgen levels in many women with PCOS.". The hormone group is androgens. The other choices are not the stated hormonal effect of weight loss in this population.

   Reference: ASRM Polycystic Ovary Syndrome — How Is PCOS Treated in Women Not Trying to Get Pregnant?

9. 9During an IVF stimulation protocol, a GnRH antagonist is added. Which event is it intended to prevent?

   1. A.Inadequate luteal progesterone support
   2. B.A premature LH surgeCorrect answer: B
   3. C.Persistent prolactin elevation
   4. D.Excess adrenal androgen production

   Explanation: The source states, "Treatment with a GnRH agonist or antagonist reduces the possibility of premature LH surges from the pituitary gland, and thereby reduces the risk of premature ovulation.". The stated purpose is preventing a premature LH surge and ovulation. The other endocrine targets involve different pathways or treatment needs.

   Reference: ASRM Assisted Reproductive Technologies — Ovarian Stimulation

10. 10A patient has high prolactin attributable to primary hypothyroidism. Which treatment addresses the identified endocrine cause?

    1. A.A GnRH antagonist
    2. B.An androgen receptor antagonist
    3. C.Thyroid hormone replacementCorrect answer: C
    4. D.An aromatase inhibitor

    Explanation: The source states, "Hypothyroidism is treated with thyroid replacement medicine, which should also make prolactin levels return to normal.". Correcting the thyroid deficiency addresses this cause of high prolactin. The other agents act on different endocrine pathways.

    Reference: ASRM Hyperprolactinemia — How Is Hyperprolactinemia Treated?