Child with primary amenorrhea with negative progesterone challenge test but positive combined progesterone and estrogen test. Diagnosis may be:

This child is presenting with primary amenorrhea with: • Negative progesterone challenge test - which rules out PCOD (which may sometimes manifest as primary amenorrhea) • When next step was done i.e., estrogen, progesterone combined test - It comes out to be positive i.e., compartment I system (uterus, endometrium and outflow tract) is normal if properly stimulated by estrogen which rules out mullerian agenesis and Ashermann’s syndrome. • Positive estrogen progesterone combined test means the defect is in the production of estrogen i.e., either ovaries, pituitary, or hypothalamus. So from the given options we have to look for a cause which involves either of the above sites, which in this case is prolactinoma.