One major cause of infertility linked to Gonorrhea is:

The connection between Gonorrhea and infertility primarily arises through the development of pelvic inflammatory disease (PID). When Gonorrhea is left untreated, the bacteria can ascend from the cervix into the upper reproductive tract, leading to inflammation and infection of the uterus, fallopian tubes, and ovaries. This condition can cause scar tissue to form and may lead to complications such as tubal factor infertility, where blocked or damaged fallopian tubes prevent sperm and egg interaction or implantation of a fertilized egg.

PID can also increase the risk of ectopic pregnancies, chronic pelvic pain, and other reproductive health issues, thereby significantly affecting a person's ability to conceive. Addressing and treating Gonorrhea promptly is essential to prevent the onset of PID and its associated risks of infertility.

The other options, while they may relate to health in different ways, do not have a direct causal link to infertility as a result of Gonorrhea. For instance, while mental health disorders can impact overall reproductive health, they are not specifically caused by Gonorrhea. Similarly, pulmonary embolism is a serious medical condition that is unrelated to the mechanisms of infertility linked to sexually transmitted infections. Hormonal balance can affect fertility, but it is not a direct consequence of Gonorrhea infection