<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 32-year-old G0P0 female complains of unsuccessful pregnancy since discontinuing an oral contraceptive 12 months ago. She reports menarche at age 15 and has had irregular periods since. She had occasional spotting while taking an oral contraceptive, but she has not had a normal period since discontinuing the pill. She currently denies having any hot flashes. Physical examination reveals normal height and BMI. A speculum examination shows atrophic vagina. Thyroid-stimulating hormone and prolactin concentrations are within normal limits. The patient tests negative for a qualitative serum betahCG. The laboratory findings include a follicle-stimulating hormone FSH level of 56 mIUmL and an estradiol level of 18 pmolL, confirmed by 2 separate readings within 2 months. Based on her history, physical examination, and laboratory findings, what is the most likely cause of her infertility?? A: Polycystic ovary syndrome, B: Hyperprolactinemia, C: Primary ovarian insufficiency, D: Secondary ovarian insufficiency, E: Menopause,  <response>: This is a question about infertility in a 32-year-old woman. The key findings in the history are irregular periods since discontinuing oral contraceptives 12 months ago, no normal periods since then, and no hot flashes. The physical exam shows atrophic vagina. Lab findings show normal TSH and prolactin, negative qualitative hCG, elevated FSH, and low estradiol confirmed on two tests. Based on the history of irregular periods after stopping oral contraceptives, physical exam finding of atrophic vagina, and lab findings of elevated FSH and low estradiol, the most likely diagnosis is primary ovarian insufficiency. Polycystic ovary syndrome, hyperprolactinemia, and menopause are less likely based on the provided information. Secondary ovarian insufficiency would imply a known insult to the ovaries, which is not suggested in the history.C: Primary ovarian insufficiency 