• Endometriosis, a disease in which uterine tissue is found outside of the uterus, on the ovaries, fallopian tubes and often on the bladder and bowel. It can occur in menstruating women of all ages, including teens. While the connection between endometriosis and infertility is not clearly understood, early detection may result in successful control and some improvement in fertility (though not all the way to normal). Be sure to report these symptoms: painful menstrual cramps that may be worsening with time, extremely heavy menstrual flow, diarrhea or painful bowel movements (especially around the time of your period) and painful sexual intercourse.

For men, there are a variety of factors that could lead to infertility. Many researchers believe the causes of declining male fertility during this century are environmental; they include pesticide and chemical exposure, drug use, radiation and pollution. Risks include:

• exposure to toxic substances or hazards on the job, such as lead, cadmium, mercury, ethylene oxide, vinyl chloride, radioactivity and X-rays

• cigarette or marijuana use

• heavy alcohol consumption

• prescription drugs for high blood pressure (calcium channel blockers), ulcers, and psoriasis

• DES exposure in utero

• exposure of the genitals to elevated temperatures, such as hot baths, whirlpools and steam rooms

• medical risks, including hernia repair, undescended testicles, history of prostatitis or genital infection and mumps after puberty