<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 29-year-old woman, gravida 1, para 1, comes to the physician because of difficulty conceiving for one year. She is sexually active with her husband 45 times a week. Pregnancy and delivery of her first child 3 years ago were uncomplicated. She returned to work as an event coordinator 12 months ago and has found the transition stressful. Menses previously occurred at 30-day intervals and lasted for 34 days with moderate flow. Her last menstrual period was three months ago. She has occasional vaginal dryness. The patient runs 5 to 10 miles every day. Her BMI is 19.0 kgm2. Her pulse is 73min and blood pressure is 12570 mm Hg. Abdominal examination shows no abnormalities. Pelvic examination shows dry vaginal mucosa. A serum pregnancy test is negative. Serum studies show:Prolactin 18 μgLThyroid-stimulating hormone 2.5 mULFollicle-stimulating hormone 3.6 ULLuteinizing hormone 2.3 ULUltrasound of the pelvis shows no abnormalities. In addition to dietary and exercise counseling, which of the following is the most appropriate next step in management?? A: Offer clomiphene citrate therapy, B: Offer in vitro fertilization, C: Offer pulsatile gonadotropin-releasing hormone therapy, D: Offer human chorionic gonadotropin therapy, E: Obtain MRI of the pituitary gland,  <response>: This is a question about infertility in a 29-year-old woman who has had one previous pregnancy. The key findings are:- Difficulty conceiving for 1 year despite frequent intercourse - Last menstrual period was 3 months ago- Occasional vaginal dryness- Normal prolactin and TSH levels- Normal FSH and LH levels- Normal pelvic ultrasoundThis suggests hypothalamic amenorrhea due to excessive exercise and low BMI. The next step would be counseling on dietary changes and decreasing exercise intensity to restore normal menstrual function. MRI of the pituitary is not indicated with normal prolactin and FSHLH levels. Clomiphene, IVF, hCG therapy would not address the underlying issue. C: Offer pulsatile gonadotropin-releasing hormone therapy 