A patient had a spontaneous abortion, then she came with amenorrhea and FSH 6 IU/mL. What the most probably diagnosis?

Ans. is b, i.e. Uterine SynechiaeRef: Leon speroff 7th/ed, p415-425, 8th/ed, p443 for FSH significance and 459 for asherman syndromeExplanation:Normal FSH values range from 5to20mIU/mL. In the question, FSH levels are 6mIU/mL, that means this is a case of secondary amenorrhea with normal FSH values.* In case of pituitary failure - as is evident from the flow diagram - values of FSH should be lower than the normal values. So Option'd' is ruled out* Incase of ovarian failure - estrogen is deficient so negative feedback on FSH will be absent, thus values of FSH will be more than normal. In case of ovarian failure/ menopause, FSH is above 40mIU/mL so option a is also ruled out.* Normal FSH and amenorrhea point towards uterine pathology. The patient had a spontaneous abortion following which a curettage is generally required which would be responsible for intrauterine synechiae (Asherman's Syndrome). Thus, the most probable diagnosis is uterine synechiae.KEY POINTSRememberHyperprolactinemia leads to decreased levels of FSH.