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Considering the complexity of both the male and female reproductive systems, one can truly view conception as miraculous. Any change in the complicated sequence of events can disrupt ovulation, conception or pregnancy. Here are some of the most common causes of infertility. Abnormal Ovulation Abnormal ovulation, often referred to as hypothalamic pituitary dysfunction, results in irregular or absent menstrual periods. The vast majority of the time, this is caused by a hormonal imbalance due to improper coordination and communication between the part of the brain called the hypothalamus and the pituitary gland. Together, these two organs cause the release of hormones into the bloodstream. In many cases, abnormal ovulation may also be associated with extremely low body weight or with being over weight, as well as any significant change in weight (loss or gain). Blocked Fallopian Tubes Blocked or damaged fallopian tubes may interfere with the egg and sperm uniting. Blockages may also negatively affect embryo development and implantation in the uterus. Blockages can be caused by a past infection, such as an earlier episode of pelvic inflammatory disease (PID), or abdominal surgery. Often, there are no symptoms associated with blocked or damaged fallopian tubes. Treatment of tubal problems or pelvic scarring may require specialized surgery, depending on each woman's situation. Endometriosis Every month the lining of the uterus, the endometrium, thickens in preparation for the implantation of an embryo. Sometimes the endometrial cells will migrate from their normal location and attach to the ovaries and other pelvic organs. This is called endometriosis and may cause infertility. The symptoms of endometriosis include heavy, painful, and long menstrual periods. However, there is no correlation between the severity of the symptoms and the extent of the disease. In fact, sometimes there are no symptoms at all. Several forms of treatment are available, including medication and surgery. Cervical Problems When the body is not ovulating, cervical mucus helps prevent infection by killing bacteria. However, at the time of ovulation, cervical mucus should change to encourage sperm survival. Cervical problems may be related to consistency of the cervical mucus or cervical anatomy, which will not allow the sperm to enter the uterus. Age Fertility levels decrease with age, especially in women. Maximum fertility for women occurs between the ages of 15 and 24. Many couples delay starting a family until they are in their 30s and 40s. About one third of women who defer pregnancy until their mid-30s will have a problem becoming pregnant, and at least half of all women over age 40 will have difficulties. Because the likelihood of conceiving declines with age, women over age 35 should wait no more than 6 months before seeking help if they suspect a possible problem. Male Factor Problems may be related to inadequate sperm count or abnormalities relating to size, shape, and movement of sperm. Male infertility is commonly related to the presence of a variococele, which are varicose veins in the scrotum that affect sperm quality and quantity. Testicular injury, undescended testicles, and hormonal imbalances may also cause problems with fertility. Occasionally, the presence of other disease, such as diabetes mellitus, central nervous system problems, and pituitary tumors can affect fertility. 
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