<prompt> Child with primary amenorrhea with negative progesterone challenge test but positive combined progesterone and estrogen test. Diagnosis may be:Mullerian agenesisPCODAsherman syndromeProlactinoma  <response>: This child is presenting with primary amenorrhea with: Negative progesterone challenge test - which rules out PCOD which may sometimes manifest as primary amenorrhea When next step was done i.e., estrogen, progesterone combined test - It comes out to be positive i.e., compartment I system uterus, endometrium and outflow tract is normal if properly stimulated by estrogen which rules out mullerian agenesis and Ashermanns syndrome. Positive estrogen progesterone combined test means the defect is in the production of estrogen i.e., either ovaries, pituitary, or hypothalamus.So from the given options we have to look for a cause which involves either of the above sites, which in this case is prolactinoma. 