Causes of Female Infertility

Which of the following is the most common structural cause of female infertility worldwide?

Polycystic ovary syndrome (PCOS) causes infertility primarily through which mechanism?

A 28-year-old woman with a 3-year history of primary infertility is found to have polycystic ovary syndrome (PCOS) on ultrasound and elevated androgen levels. She has regular menstrual cycles but anovulation confirmed by progesterone levels. What is the drug of choice for ovulation induction in this patient?

A 28-year-old woman with secondary infertility (1 child 5 years ago, now unable to conceive for 2 years) presents with severe dysmenorrhea and deep dyspareunia. Pelvic examination reveals a fixed, retroverted uterus and nodular thickening of the uterosacral ligaments. What is the most appropriate investigation to confirm the suspected diagnosis?

A 28-year-old nulliparous woman attends the infertility clinic with secondary infertility of 18 months. She had one child 4 years ago (vaginal delivery, no complications). Menarche at 12, cycles irregular (35–60 days), heavy periods (flooding, passage of clots). BMI 31 kg/m². Hirsutism present. Pelvic ultrasound shows bilateral polycystic ovaries. Husband's semen analysis is normal. What is the most appropriate next step in management?