Ovulation disorders - A delicate balance of sex hormones (oestrogen, progesterone, luteinizing hormone, follicle stimulating hormone) is needed for the timely growth and release of the egg from the ovary (ovulation).Hormone imbalances can cause ovulation disorders in women and are the most common cause of infertility in women.

Polycystic Ovary Syndrome (PCOS) - Another cause of anovulation is PCOS. Hormonal problems are sometimes found and on scan the ovary has lots of small cysts around the edge. These are not harmful in themselves, just a sign that eggs have started to develop, but never got released.

Clomifene Citrate(Clomid) - Commonly used to start the ovaries ovulating again. Clomid is taken on days 2-6 of a cycle and it’s Kick-starts The ovary into making and releasing an egg. A day 21 progesterone level in the first cycle will check that it has worked, but some women need a higher dose. It is a safe drug but, as with most ovulation treatments, it increases the risk of a multiple pregnancy, such as twins. This happens in about 1 in 20 women treated with clomiphene.

Ovarian Drilling - A treatment that is used in PCOS where clomiphene is unsuccessful. Several small holes are made in the ovary during a laparoscopy, and this reverses the hormone problems associated with the disease. The success rate depends on many factors, but typically around 50% of women fall pregnant within 1-2 years of treatment and by 3 years about 75% are successful.

Ovarian Stimulation - A more intensive treatment, which uses injections of hormones on a daily basis and close ultrasound monitoring of the ovary’s response. The aim is to produce several good quality eggs and time their release with intercourse. Side effects include multiple pregnancy (10-20%), an increased risk of ectopic pregnancy and a condition called ovarian hyperstimulation syndrome, where an unexpectedly excessive response occurs and large ovarian cysts develop. The success rates vary greatly depending on the individual situation, but 40-85% after 6 treatment cycles is typical. Success after 6 cycles is less likely, though not impossible, and IVF is usually advised if this is unsuccessful.

Stress -Stress can be detrimental to both mother and baby as it can cause high blood pressure and even spontaneous labor in some cases.

Fallopian tube damage - It is in the fallopian tube that fertilization takes place, after the egg is released from the ovary into the tube and is met by sperm. Full or partial blockage of the fallopian tubes will prevent fertilization taking place. Fallopian tubes can be damaged by inflammation that results from viral or bacterial infections, some types of sexually transmitted diseases, or complications of surgery such as adhesions or scarring.

Uterus and cervical disorders - Benign growths on the uterine wall, such as fibroids or polyps, can also contribute to infertility as they interfere with the attachment of the embryo onto the uterus wall. Abnormalities in the shape of the cervix or changes in the texture of the cervical mucus can make it difficult for the sperm to move from the vagina into the uterus.

Endometriosis - Endometriosis is a condition where the lining of the uterus forms at inappropriate places within and outside of the reproductive tract. It can block the fallopian tubes and/or disrupt ovulation. It occurs in about ten per cent of women.

Immunological factors - The presence of antibodies to sperm in cervical mucus can cause infertility. In other cases, the mother's immune system prevents the embryo from attaching to the wall of the uterus and so causes a miscarriage.

Polycystic ovaries - Polycystic ovaries contain lots of small cysts, making the ovary larger than normal. The condition, called polycystic ovarian disease (PSOD), is also associated with high levels of androgen and oestrogen. Women with PSOD have irregular periods and may not ovulate, resulting in infertility.

Ovarian failure - Ovarian failure can be a consequence of medical treatments (for ovarian tumors for instance), or the complete failure of the ovaries to develop or contain eggs in the first place (for example, Turner's syndrome).The treatment for ovarian tumors may involve surgical removal of all or part of the ovary. Ovarian failure can also occur as a result of treatments such as chemotherapy and pelvic radiotherapy for cancers in other body areas. These therapies destroy eggs in the ovary.

Ageing - Age is a critical factor affecting a woman's fertility .Woman in our society many women choose to delay having children. Some of the common reasons for this include education and career demands, financial stability, second marriages/relationships and waiting for a suitable partner.

Reproductive function declines as a woman ages, particularly after the age of 35. Women are born with a finite number of eggs, unlike men who produce sperm most of their adult life. In the years approaching menopause, there are fewer and fewer eggs left in the ovary. The quality of eggs also diminishes as a woman gets older. When a woman is in her late thirties, there is an increase in chromosome abnormalities that can result in birth defects like Down syndrome.