Depression is very common in women who are trying to become pregnant. In fact, depression may have a direct effect on hormones that regulate reproduction. In men, sperm defects are usually responsible. Female infertility is more complex. Although PID can be a result of nonsterile abortions, use of an IUD, or a ruptured appendix, most infections are caused by sexually transmitted diseases.
Gonorrhea is responsible for most of the remaining cases.
Severe or frequent attacks of PID can eventually cause scarring, abscess formation, and tubal damage that result in infertility. The severity of the infection, not the number of the infections, appears to determine the risk for infertility. PID also significantly increases the risk of ectopic pregnancy. This disorder develops when fragments of the endometrial lining are implanted in other areas of the pelvis. These endometrial implants develop into cysts, which respond like mini-uteruses to hormonal changes, slowly increasing in size with each menstrual cycle and eventually causing scarring and inflammation.