How is purified follicle-stimulating hormone (FSH) (urofollitropin [Metrodin]) administered to an infertile woman as part of the pharmacologic treatment?

Choice A reason: This is not the main reason, as the use of contraceptives for an extended time does not necessarily affect the fertility of a woman. Most contraceptives are reversible and do not cause permanent damage to the reproductive system. However, some contraceptives may take longer to wear off than others, and some may have side effects that can interfere with ovulation or implantation.

Choice B reason: This is the main reason, as the aging process can affect the ovaries and the quality and quantity of the eggs. As a woman ages, her ovarian reserve (the number of eggs in the ovaries) declines, and the eggs become more prone to chromosomal abnormalities. This can reduce the chances of conception and increase the risk of miscarriage or birth defects.

Choice C reason: This is not the main reason, as prepregnancy medical attention is not a prerequisite for achieving pregnancy. However, prepregnancy medical attention can be beneficial for a woman who is older than 35 years, as it can help identify and manage any existing or potential health problems that may affect the pregnancy, such as diabetes, hypertension, or thyroid disorders.

Choice D reason: This is not the main reason, as personal risk behaviors are not specific to a woman who is older than 35 years. Personal risk behaviors are factors that can negatively affect the fertility of any woman, regardless of age. Some examples of personal risk behaviors are smoking, drinking, using drugs, having multiple sexual partners, or having sexually transmitted infections.

Choice A reason: This is the best advice for the woman, as it acknowledges that jogging is safe and beneficial in early pregnancy, but also informs her that she may need to adjust her exercise intensity and duration as her pregnancy progresses. Walking is a low-impact aerobic activity that can be done throughout pregnancy, as long as there are no complications or contraindications. Walking can help maintain cardiovascular fitness, prevent excessive weight gain, and reduce the risk of gestational diabetes and preeclampsia.

Choice B reason: This is not a good advice for the woman, as it implies that jogging is harmful for her joints and that she should stop it immediately. Jogging is not necessarily bad for the joints, as long as the woman wears appropriate shoes, avoids uneven surfaces, and listens to her body. Jogging can also provide many health benefits for the woman and the fetus, such as improved mood, increased energy, and reduced stress².

Choice C reason: This is a false and alarming statement that may discourage the woman from exercising at all. Exercise during pregnancy is not dangerous for the fetus unless there are specific medical conditions or complications that prevent it. Exercise during pregnancy can improve the fetal growth, development, and oxygenation, as well as reduce the risk of preterm birth and low birth weight.

Choice D reason: This is an unrealistic and misleading statement that may cause the woman to overexert herself or ignore the signs of discomfort or fatigue. Exercise during pregnancy may need to be modified according to the woman's changing needs, abilities, and preferences. Some factors that may affect the type, frequency, intensity, and duration of exercise during pregnancy include the trimester, the fetal position, the maternal weight, the environmental temperature, and the presence of any symptoms or complications.