C-RHI Study Guide: Endocrinology, Infertility Workup, ART, Ethics

Reproductive Anatomy, Physiology & Endocrinology (25%)

• Learn the HPO axis as an interconnected system, not isolated hormone facts — understand how GnRH, FSH, LH, estradiol, and progesterone influence each other across the cycle.
• Distinguish the follicular and luteal phases clearly, including which hormone dominates each and what physiological changes occur.
• Understand ovarian reserve markers (AMH, antral follicle count) and what they indicate about fertility potential.
• Review age-related fertility decline mechanisms for both female and male patients, since this connects to treatment planning content too.

Infertility Evaluation & Diagnosis (25%)

• Know the clinical definition of infertility precisely, including the modified timeline for patients over 35.
• Learn semen analysis terminology distinctly — azoospermia, oligospermia, asthenospermia, teratospermia — since these are commonly confused.
• Review diagnostic imaging and testing purposes (HSG, sonohysterogram, ovulation confirmation) and what each is specifically used to evaluate.
• Understand common causes of infertility (tubal factor, ovulatory dysfunction, endometriosis, male factor) and their general evaluation approach.

Assisted Reproductive Technology & Treatment Management (30%)

• Walk through a full IVF cycle sequence from stimulation through transfer and luteal support, understanding why each step occurs when it does.
• Distinguish GnRH agonist and antagonist protocols, and understand the purpose of the trigger shot in cycle timing.
• Learn OHSS risk factors and monitoring priorities thoroughly, since this is a concrete, safety-critical topic.
• Review cryopreservation and fresh versus frozen embryo transfer concepts, including vitrification as the standard freezing technique.

Psychosocial, Ethical & Professional Issues (20%)

• Study the psychological impact of infertility and treatment failure specifically, not just as a general "be supportive" concept.
• Review ethical considerations in embryo disposition and third-party reproduction, since these are specific, testable ethical topics unique to this specialty.
• Understand informed consent's particular importance in ART, given the complexity and risk profile of fertility procedures.
• Know the four core ethical principles (autonomy, beneficence, nonmaleficence, justice) as applied specifically to fertility care scenarios.

General Strategy: Connect Physiology to Practice

Because ART protocols are direct clinical applications of reproductive endocrinology principles, studying the two domains together — rather than as separate silos — reinforces both and mirrors how the exam actually tests applied clinical reasoning.

Put These Tips Into Practice

Our C-RHI exam page has free practice quizzes broken out by domain, plus a full mock exam, to help you target your remaining study time.

Official source: eligibility, fees, and the current content outline are set by National Certification Corporation (NCC). Confirm the details there before you register.