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In this procedure, 5–10 mm diameter instruments (graspers, scissors, clip applier) can be introduced by the surgeon into the abdomen through trocars (hollow tubes with a seal to keep the CO 2 from leaking). If the sperm are of good quality and the mechanics of the woman's reproductive structures are good (patent fallopian tubes, no adhesions or scarring), a course of ovulation induction maybe used. A small incision is made in the abdomen, and a thin, flexible microscope with a light at the end, called a laparoscope, is inserted through it. Hjollund NH, Storgaard L, Ernst E, Bonde JP, Olsen J. Oligospermia is defined as fewer than 20 million sperm/mL, severe oligospermia is less than 5 million/mL, and azoospermia is defined as no sperm present. Pregnancy with Sperm Aspiration from the Proximal Head of the Epididymis: A New Treatment for Congenital Absence of the Vas Deferens. (PDF, 2 MB) Fertility and Sterility, 1988.

Judaism and Repoductive Technology. (PDF, 160 KB) 2003. In some cases, the cause of infertility or subfertility could not be suspected from the history taking and clinical examination. Endometriosis Endometriosis is when the tissue of the uterine lining grows outside of the uterus. Reproductive Biology. (PDF, 147 KB) The Scientist, 1996. Additional tests to determine sterility include blood tests, an ultrasound of the ovaries, hysterosalpingography to check for physical problems of the uterus and fallopian tubes. There may be testicular malformations, hormone imbalance, or blockage of the man's duct system.

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The rising number of obese individuals may be due in part to an energy-rich diet as well as insufficient physical exercise.  In addition to other potential health risks, obesity can have a significant impact on male and female fertility. Laparoscopy with hydrotubation - if the clinical situation suggests this is required . Some methods may be used in concert with other methods.

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Women in group II include those with polycystic ovary syndrome and hyperprolactinemia. Low weight: Obesity is not the only way in which weight can impact fertility. Since they will still be working with scopes and other laparoscopic instruments, CO2 will have to be maintained in the patient's abdomen, so a device known as a hand access port (a sleeve with a seal that allows passage of the hand) must be used. Hyperprolactinemia: If prolactin levels are high, and the woman is not pregnant or breastfeeding, it may affect ovulation and fertility.

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Sexually transmitted infections (STIs): Chlamydia can damage the fallopian tubes in a woman and cause inflammation in a man's scrotum. IVF treatment may be suggested if IUI is not successful or appropriate, or if female infertility is a contributing problem. Thyroid dysfunction can halt ovulation by upsetting the balance of the body’s natural reproductive hormones. Testicular Neoplasm in Father and Son. (PDF, 561 KB) The Journal of Urology, 1972. 7 million women reported impaired ability to get pregnant or carry a baby to term. Obesity can increase the risk for other conditions that may impact a man's fertility such as sperm quality and sexual dysfunction.