There are many causes of infertility, so depending on different reasons, the clinical manifestations also vary. For instance, some women suffer from infertility due to abnormal ovulation, which could manifest as abnormalities in the menstrual cycle such as prolonged absence of menstruation, like in polycystic ovary syndrome, or irregular vaginal bleeding. Some women have uterine factors that cause infertility, such as common post-multiple intrauterine operations leading to intrauterine adhesions, where a woman might experience reduced menstrual flow or even amenorrhea, accompanied by painful menstruation. Additionally, infertility in some women might be due to cervical factors, possibly presenting with thick vaginal discharge, contact bleeding, or blood-tinged discharge. Partially, some women might have ovarian endometriomas, which can cause severe painful menstruation and increased menstrual volume, among other symptoms.