Hi, First of all it s sad to know what your sister had been going through lately. Based on the history you have shared, she is having secondary infertility. Cause should be identified and treated accordingly. As sometimes structural lesions or obstructive causes may lead to secondary infertility and surgical intervention helps. Ultrasound pelvis and hormonal profile, as well as a detailed review by a fertility specialist, can be helpful and medical therapy should be started afterward. Also, other mechanisms like in vitro fertilization, etc should be discussed. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Saddiq Ulabidin, General & Family Physician