11th April 2024

Investigations

After excluding pregnancy, initial biochemical tests include FSH, LH, TSH and prolactin. If there are systemic features of androgen excess, total testosterone levels could be considered. A pelvic ultrasound should be considered if an anatomical abnormality of the genital tract is suspected. Diagnosis of POI in women <40 years is based on clinical features such as oligomenorrhoea/amenorrhoea >4 months and biochemical confirmation of hypergonadotropic hypogonadism (two raised FSH (>30) levels taken at a 4–6-week interval). Hysteroscopy is the gold standard for diagnosing Asherman’s syndrome.