In a case of amenorrhea with normal prolactin, no response to estrogen-progesterone challenge, and a history of DIC, what is the likely diagnosis?

A case presenting with amenorrhea, normal prolactin levels, lack of response to an estrogen-progesterone challenge, and a history of DIC suggests a diagnosis of Asherman's syndrome. In this condition, intrauterine adhesions form due to trauma to the uterus, such as that which can occur after a surgical procedure or significant bleeding associated with disseminated intravascular coagulation (DIC). The absence of a menstrual response after hormone administration indicates that the endometrial lining is likely compromised or not functioning properly, which is characteristic of Asherman's syndrome.

The history of DIC is particularly relevant, as it can lead to the formation of scar tissue in the uterus, contributing to this syndrome. In cases of Asherman's syndrome, patients may experience secondary amenorrhea due to the presence of intrauterine adhesions, which block the normal shedding of the endometrium during the menstrual cycle. This aligns with the presentation of the patient in the given case.

In contrast, primary ovarian insufficiency would typically present with elevated gonadotropins (FSH and LH) and could lead to a secondary amenorrhea scenario, but the normal prolactin levels and lack of response to hormonal challenge point away