Introduction
Infertility is a condition when conception does not take place even after one year of regular, unprotected sexual intercourse. It can affect either the male or female. It can be due to a variety of factors including endocrine disorders, defects in the reproductive systems, deficient production of sperms or eggs, drugs and toxic chemicals, childhood diseases such as mumps, etc. There has been a recent increase in the number of infertility cases reported throughout the world.

Cause and Pathogenesis
Infertility is caused due to a multitude of factors both in the male and the female. In the male, a low sperm count or defective spermatozoa is a major factor. Another common factor that contributes to male infertility is the presence of a varicocele, which is a cluster of enlarged veins around the testicle. Varicocele elevates temperature in this part of the body by increasing blood circulation and the higher temperature reduces sperm production. Defects in the male reproductive tract can also be responsible for infertility. Childhood disorders such as mumps may result in permanent damage of the reproductive organs, leading to infertility. The use of certain drugs and toxic chemicals can contribute to infertility. In females, Pelvic Inflammatory Disease (PID) is the major cause of infertility throughout the world. PID covers a wide variety of infections that can affect the uterus, ovaries, and fallopian tubes. The sites of infection that usually cause infertility are the fallopian tubes, the inflammation of which produces a condition known as salpingitis.

Most infections are caused by sexually transmitted diseases. Chlamydia trachomatis is an infectious organism that causes a large proportion of salpingitis cases. Gonorrhea is responsible for much of the rest. Attacks of PID can eventually cause scarring, abscess formation, and tubal damage that result in infertility. Endometriosis is responsible for a substantial proportion of cases. It results when fragments of the endometrial lining are implanted in other areas of the pelvis, which then develop into cysts and respond to hormonal changes, increasing in size with each menstrual cycle and eventually causing scarring and inflammation. Endometrial implants in the ovaries or fallopian tubes are especially prone to cause infertility. Ovulatory and hormonal problems are responsible for almost 30% of infertility cases in women. These problems result in the failure of the ovarian follicle to rupture, an empty follicle, or entrapment of the egg so that it is not released. Polycystic Ovarian Syndrome (PCO) occurs in 6% of women and is also major cause of infertility.

Some cases of unexplained infertility may result from early loss of ovarian function. Immune system failure can also cause infertility. Scar tissue that forms after abdominal surgery can restrict the movement of ovaries, fallopian tubes, or the uterus and may cause infertility. Other causes of infertility include a ruptured appendix, diabetes, kidney disease, thyroid disorders, hypertension, drugs, and toxic chemicals.

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