Role of surgery to optimise outcome of assisted conception treatments


  • Yalanadu Narendra Suresh MD DNB MRCOG DFFP,

    Corresponding author
    1. Honorary Consultant, Assisted Conception Unit, Kings College Hospital NHS Foundation Trust, London, UK
    • Consultant Obstetrician and Gynaecologist with a special interest in Early Pregnancy and Emergency Gynaecology, Fertility and Laparoscopy, Great Western Hospital, Swindon, UK
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  • Nitish Narvekar MD MFSRH MRCOG

    1. Consultant in Obstetrics, Gynaecology and Reproductive Medicine, Specialist in Assisted Conception and Minimal Access Surgery, King's College Hospital NHS Foundation Trust, Obstetrics and Gynaecology, Denmark Hill, London, UK
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Correspondence: Yalanadu Suresh. Email:


Key content

  • Assisted conception technology such as in vitro fertilisation (IVF) is the first-line treatment of many causes of female subfertility and surgery is offered primarily to optimise the outcome of such treatments.
  • An awareness and understanding of the evidence about the different surgical interventions used prior to assisted conception is essential in achieving the best possible outcome.

Learning objectives

  • To assess the fertility needs of women including the need for surgery.
  • To understand the role of different surgical interventions prior to assisted conception for the management of hydrosalpinx, uterine fibroids, uterine pathology such as a uterine septum and intrauterine adhesions, and the treatment of endometriosis and ovarian endometriomas.

Ethical issues

  • Women should be counselled about the benefits and risks of surgery including the risk of delay to their assisted conception.
  • A sympathetic approach is needed for women who are already emotionally and physically stressed.
  • There are financial implications involved in IVF treatment.
  • Psychosocial issues and anxiety require a multidisciplinary approach.