19th April 2022

A 24-year-old woman comes into her GP practice concerned about being infertile

A 24-year-old woman comes into her GP practice concerned about being infertile. She has been having regular unprotected sex with her partner for around 2 years now, and has not used hormonal contraception before this, just barrier. She has no past medical history and doesn’t take any medications apart from a multivitamin daily. She has been menstruating throughout the two years, but her periods sometimes come out of the blue, which is normal for her. There is no dyspareunia.

You confirm she is not pregnant with a urine pregnancy test. On examination you notice she has a larger habitus, and some small dark hairs on her chin. An abdominal exam shows no obvious abnormalities.

What is the most likely cause of the subfertility in this patient?

Select the SINGLE most appropriate option from the list below. Select ONE option only.