The official National Certification Corporation candidate guide divides the examination content into five areas:
- GENERAL ASSESSMENT, REPRODUCTIVE ANATOMY, AND PHYSIOLOGY: 20%
- PATHOPHYSIOLOGY, EVALUATION, AND DIAGNOSIS OF REPRODUCTIVE HEALTH DISORDERS: 25%
- NON-ASSISTED REPRODUCTIVE TECHNOLOGIES (NON-ART) TREATMENT AND COMPLICATIONS: 12%
- ASSISTED REPRODUCTIVE TECHNOLOGIES (ART) TREATMENT AND COMPLICATIONS: 24%
- REPRODUCTIVE HEALTH TREATMENT AND COMPLICATIONS: 19%
The weighting is fairly distributed, with two slightly larger domains covering diagnosis and ART. Build a balanced plan, then use MedPorium's free C-RHI diagnostic to adjust it around your personal gaps.
What is the C-RHI exam?
The C-RHI exam focuses on reproductive health and infertility knowledge across assessment, diagnosis, treatment, procedures, complications, and psychosocial care. The outline follows a useful clinical sequence: gather a relevant history, understand normal reproductive function, investigate possible causes, select or monitor treatment, recognise complications, and support informed care.
Your preparation should therefore go beyond memorising a list of disorders or medications. Practise connecting findings to the next appropriate assessment, explaining why a procedure is used, distinguishing related treatment pathways, and recognising the safety or counselling issues that accompany them.
What topics are covered?
GENERAL ASSESSMENT, REPRODUCTIVE ANATOMY, AND PHYSIOLOGY: 20%
This domain covers medical, reproductive, lifestyle, sexual, and genetic history. Review how age, medications, supplements, diet, exercise, BMI, and teratogenic exposure can affect reproductive planning and evaluation. Build a repeatable history framework so that you can identify what information is relevant in a short case.
Screening and counselling include infectious disease and immunisation screening, genetic carrier screening, pelvic examination, ovarian reserve assessment, preconception laboratory work, imaging of the reproductive tract, semen analysis, and scrotal ultrasound. For each test, know its purpose, the part of the evaluation it informs, and what a result may prompt next.
The domain also includes menstrual-cycle phases and hormonal changes, implantation timing, fertility tracking, reproductive ageing, puberty, and Tanner stages. Draw the cycle from memory and annotate the major hormonal and physiologic changes. That diagram becomes a foundation for later treatment topics.
PATHOPHYSIOLOGY, EVALUATION, AND DIAGNOSIS OF REPRODUCTIVE HEALTH DISORDERS: 25%
This is the largest domain. It includes disorders of the hypothalamic-pituitary-ovarian axis, thyroid disease, polycystic ovary syndrome, diminished ovarian reserve, structural tubal, cervical, and uterine disorders, and endometriosis. Study each condition through presentation, relevant history, evaluation, and how the findings distinguish it from another cause.
Male-factor topics include semen parameters, varicocele, heat or injury exposure, anabolic steroid misuse, low testosterone, sexual dysfunction, undescended testes, prior chemotherapy or radiation, vas deferens abnormalities, retrograde ejaculation, and vasectomy. Avoid treating the semen analysis as a single result: understand count, motility, and morphology as separate information.
Genetic and congenital disorders, unexplained infertility, and recurrent pregnancy loss complete the domain. Compare inheritance patterns and the named syndromes, then organise recurrent pregnancy loss by genetic, anatomic, autoimmune, and metabolic causes. The goal is a structured differential rather than isolated recall.
NON-ASSISTED REPRODUCTIVE TECHNOLOGIES (NON-ART) TREATMENT AND COMPLICATIONS: 12%
This smaller domain covers lifestyle modification, ovulation induction, intrauterine insemination, reproductive surgery, and male therapies. Review nutrition and exercise advice within the clinical context, then connect ovulation-induction protocols with pharmacotherapy and monitoring.
Know the practical sequence of IUI, including sperm preparation and donor sperm considerations. Compare male and female surgical options by their purpose. For a scenario, ask what problem the treatment addresses, what monitoring is needed, and what finding could change the plan.
ASSISTED REPRODUCTIVE TECHNOLOGIES (ART) TREATMENT AND COMPLICATIONS: 24%
This substantial domain follows in vitro fertilisation from pretreatment and ovarian stimulation through trigger, retrieval, transfer, and luteal support. Compare antagonist, flare, and down-regulation protocols at a conceptual level and place each step in the correct sequence.
Review ICSI, PICSI, TESE, MESA, and PESA by indication and role. Distinguish PGT-A, PGT-M, and PGT-SR and understand why mosaicism matters. Third-party reproduction includes indications, donor tissue, directed versus non-directed donation, gestational carriers, and the regulatory topic named in the outline.
Fertility preservation includes ovarian tissue, oocyte, sperm, and embryo freezing, including oncofertility. Also study early embryo development, grading, assisted hatching, biopsy, and frozen embryo transfer protocols. Finish with quality assurance, cycle cancellation, multiple gestation, guidelines, outcome data, benchmarking, and regulatory reporting.
REPRODUCTIVE HEALTH TREATMENT AND COMPLICATIONS: 19%
This domain broadens the scope to endocrine treatment, contraception and hormone management, early pregnancy, chronic pelvic pain, ethical and cultural aspects, and psychosocial support. Compare oral, non-hormonal, intrauterine, injectable, ring, and other hormonal approaches by their general role rather than memorising a disconnected catalogue.
For early pregnancy, review expected ultrasound findings and complications involving multiple pregnancy, selective reduction, and ectopic pregnancy, including the treatment approaches named in the outline. For chronic pelvic pain, organise pharmacologic, surgical, physical therapy, and TENS options around the problem being addressed.
The domain explicitly includes disparities, transfer recommendations, transgender care, counselling, stress management, failed cycles, closure, and pregnancy after infertility. These are part of competent care, not optional additions to the biomedical material.
How to study for the C-RHI exam
Start with a domain checklist and label each topic as explain, apply, or review. Give diagnosis and ART slightly more time, but keep every domain in weekly rotation. Build study sessions around patient pathways rather than textbook chapters.
- Gather the history and identify relevant risk factors.
- Describe the normal anatomy, physiology, or cycle involved.
- Choose the assessment that would clarify the problem.
- Interpret the likely pattern and build a differential.
- Compare appropriate treatment paths and monitoring.
- Identify complications, counselling needs, and follow-up.
Create comparison tables for tests, ovulation-induction approaches, non-ART versus ART pathways, PGT types, and fertility-preservation options. Use a timeline for IVF so that medication, monitoring, retrieval, laboratory procedures, transfer, and luteal support remain connected.
How practice questions help
Practice questions reveal whether you can select relevant information and apply it. After every question, name the task being tested: assessment, diagnosis, treatment selection, monitoring, complication recognition, or counselling. Record the clue you missed and the principle that resolves the item.
Use C-RHI practice questions in focused sets while learning a domain. Later, mix domains so you must decide whether a scenario belongs to basic assessment, diagnosis, non-ART treatment, ART, or broader reproductive health care.
Common mistakes to avoid
- Studying only infertility treatment. Assessment, physiology, contraception, early pregnancy, pain, and psychosocial care are also represented.
- Memorising abbreviations without indications. Know what each test or procedure contributes to care.
- Separating male and female evaluation completely. Many cases require a coordinated assessment.
- Ignoring monitoring and complications. Treatment questions may turn on a change that requires reassessment.
- Neglecting ethical, cultural, and emotional care. These topics are explicit in the official outline.
How MedPorium can help
Begin with the free C-RHI diagnostic, use practice questions to apply the official topics, and ask the exam-trained AI tutor to compare procedures, build fictional cases, or clarify why a particular assessment fits a scenario.
Keep the official NCC candidate guide as your scope checklist. MedPorium is not affiliated with or endorsed by the National Certification Corporation.
Final study tips
Revisit the menstrual cycle, assessment pathways, and treatment sequences regularly. In your final review, prioritise recurring errors and practise moving from history to investigation, diagnosis, treatment, monitoring, and support without relying on domain labels.
FAQ
Which C-RHI domain should I study most?
Pathophysiology, Evaluation, and Diagnosis of Reproductive Health Disorders has the largest published weighting at 25%, closely followed by ART Treatment and Complications at 24%.
Should I study non-ART if it has the smallest weighting?
Yes. It accounts for 12% and includes common treatment pathways that also help you distinguish non-ART from ART care.
How should I organise the procedures?
Group them by purpose and place them in a patient-care sequence. Include indications, major steps, monitoring, and relevant complications.
What should guide my final review?
Use the official NCC candidate guide applicable to your examination and your own error log.