When surgery has a role
Reproductive surgery is considered when a structural or anatomic finding is contributing to infertility or symptoms — for example, uterine fibroids distorting the cavity, endometriosis with pain or infertility, uterine polyps, adhesions from prior surgery or infection, a uterine septum, a hydrosalpinx, or ovarian cysts affecting function.
Common procedures
Not every finding requires surgery. When surgery is on the table, the goal is the smallest, most targeted intervention that fixes the problem and preserves reproductive tissue.
- Hysteroscopy — camera-guided evaluation of the uterine cavity, with removal of polyps, fibroids inside the cavity, or a uterine septum
- Laparoscopy — minimally invasive access to the pelvis for excision of endometriosis, removal of ovarian cysts, or management of tubal disease
- Myomectomy — removal of fibroids while preserving the uterus, laparoscopic or open depending on size and location
- Salpingectomy or tubal repair — for a hydrosalpinx before IVF, or, in select cases, tubal repair or ligation reversal
- Ovarian cyst removal — for cysts that are symptomatic, growing, or interfering with a planned cycle
Deciding between surgery and IVF
For some diagnoses — for example a small hydrosalpinx or a large fibroid distorting the cavity — surgery clearly improves the chance of pregnancy. For others, IVF may bypass the anatomic issue with fewer downsides than surgical repair. Age, ovarian reserve, other fertility factors, operative risks, recovery time, and how surgery might affect ovarian function are weighed together before recommending a path.
Recovery and follow-up
Most reproductive procedures are outpatient. Recovery ranges from a few days for hysteroscopy to several weeks for open myomectomy. A follow-up plan — imaging, timing for the next cycle, and any medications — is set before you leave the operating room.