Surgery to support fertility.
When a structural issue stands in the way, surgery can help address it. At RMA of Michigan, we use minimally invasive techniques and compassionate, evidence-informed care to treat conditions that can affect fertility.
What is fertility surgery? When non-surgical treatments aren't enough, surgery can correct structural issues in the reproductive system — removing growths, repairing the uterus, or treating conditions that may affect fertility. At RMA of Michigan in Troy, the most common procedures are hysteroscopy, laparoscopy, and myomectomy, most performed in a minimally invasive way.
Understanding fertility surgery
Sometimes a structural or anatomical issue stands in the way of conception or a healthy pregnancy. When non-surgical approaches aren't enough, surgery can remove obstructions, repair abnormalities, or treat underlying conditions in the reproductive system.
Most fertility surgeries today are minimally invasive, using small incisions or no incisions at all, which often means less discomfort and a quicker recovery than traditional open surgery.
Your physician will recommend surgery only when it's likely to help, and will explain the approach, what to expect, and how it fits with treatments such as IVF or IUI.
Surgical procedures we perform
These are the three procedures most often used in fertility care. Your physician will recommend the approach that fits your situation.
Hysteroscopy
A thin, lighted scope is passed through the cervix to view inside the uterus — no incision needed. The physician can take a closer look and treat issues in the same visit, often in about 15–30 minutes.
Often used for: fibroids, polyps, scarring (Asherman's syndrome), and differences in the shape of the uterus.
Laparoscopy
Through a small incision near the navel, a lighted scope lets the surgeon view and treat the ovaries, fallopian tubes, and uterus. Most people return to regular activities within about a week.
Often used for: endometriosis, ovarian cysts, fibroids, adhesions (scar tissue), and the effects of pelvic infections.
Myomectomy
Removes uterine fibroids while keeping the uterus intact — so the option to carry a pregnancy is preserved. It may be done by hysteroscopy, laparoscopy, or open surgery, depending on the fibroids.
Often considered for: fibroids causing heavy bleeding or pelvic pain, or affecting fertility or the shape of the uterus.
The surgical journey, step by step
While each procedure is different, most follow a similar path from evaluation through recovery. Your specifics are individualized.
Evaluation
Imaging and testing — such as ultrasound or hysteroscopy — help identify the issue and confirm whether surgery is likely to help.
Planning
Your physician recommends the approach and explains what to expect, including the type of anesthesia and the goals of the procedure.
The Procedure
Most procedures are minimally invasive and done as outpatient surgery, often taking under an hour depending on complexity.
Recovery
Recovery ranges from a day or two to a few weeks depending on the procedure, and your team gives you a plan suited to it.
Next Steps
Once you've healed, your physician discusses next steps, which may include trying to conceive or continuing with treatment.
Conditions fertility surgery can treat
Surgery is considered when a structural or anatomical issue may be affecting fertility. These are some of the most common reasons it's recommended.
- Uterine fibroids — non-cancerous growths in or on the uterus that can affect conception or pregnancy.
- Polyps — growths in the uterine lining that may cause bleeding or affect fertility.
- Endometriosis — tissue similar to the uterine lining growing outside the uterus, which can cause pain and affect fertility.
- Scarring (Asherman's syndrome) — scar tissue inside the uterus.
- Ovarian cysts & adhesions — fluid-filled sacs or scar tissue affecting the pelvic organs.
- Congenital uterine differences — variations in the shape or structure of the uterus present from birth.
Fertility surgery questions, answered
Is fertility surgery always necessary?
No. Surgery is considered only when non-surgical treatments aren't enough and a structural issue is likely affecting fertility. Your physician will recommend it only when it's likely to help in your situation.
Are these surgeries minimally invasive?
Most are. Hysteroscopy uses no incision, and laparoscopy uses small incisions, which often means less discomfort and a quicker recovery than open surgery. Some myomectomies are done minimally invasively, while larger fibroids may need open surgery.
How long is recovery?
It depends on the procedure. Many people resume normal activities within a day or two after hysteroscopy, about a week after laparoscopy, and longer after an open myomectomy. Your team will give you a personalized recovery plan.
What's the difference between a myomectomy and a hysterectomy?
A myomectomy removes fibroids while keeping the uterus intact, which preserves the option to carry a pregnancy. A hysterectomy removes the uterus entirely. The fibroid surgery offered here is fertility-sparing.
Will surgery improve my chance of getting pregnant?
By addressing a structural issue, surgery can remove a barrier to conception, though outcomes depend on your individual situation and any other factors involved. Your physician will talk through what to expect in your case.