A patient in her late twenties comes in for a routine check-up and mentions that she has been trying to conceive for over a year without success. Her menstrual cycles are regular, but she has a family history of polycystic ovary syndrome. What initial evaluation should be performed?
- (a) Serum progesterone level on day 21 of the cycle
- (b) Transvaginal ultrasound to assess ovarian morphology ✓
- (c) Hysterosalpingography to evaluate tubal patency
- (d) Serum testosterone level
Considering all options and their relevance to her situation, a transvaginal ultrasound (option b) stands out as the most appropriate initial evaluation. It allows for direct visualization of ovarian morphology and can reveal characteristics indicative of PCOS such as cystic changes or increased ovarian volume.
