Chapter 17 - The role of surgery in female subfertility

Summary

Surgery was the only means to alleviate female subfertility in many situations, when the pelvic organs developed abnormally or were altered by an acquired, often infectious, disease. Reconstructive surgery of pelvic organs includes tubal damage, ovarian cysts, and uterine myomas. Ovarian cysts are not associated with infertility, except in the case of endometriosis. Nevertheless, surgery of benign ovarian cysts is considered as being a standard gynecological procedure, but carries the potential risk of creating an ovarian insufficiency with infertility. The presence of an abnormal uterine septum is associated with an increased risk of missed abortion and premature birth. For these obstetrical reasons, section of the septum is often proposed in infertile patients, with the main reason that in the case of a pregnancy, a good deal of risk can be avoided. Surgical procedures for prevention of infertility discussed in the chapter are protection of ovaries and cryopreservation of ovaries.