GYN Surgical Treatment in Advance of IVF Improves Success Rates, According to Dr. Paul MacKoul of CIGC

Women who experience unsuccessful infertility treatments often discover that they have a treatable GYN condition like fibroids or endometriosis* that is getting in the way. If these conditions are diagnosed early enough, and treated with minimally invasive laparoscopic surgery before IVF treatments begin, studies have shown that there is a higher chance of success.

Infertility is generally defined as the inability to conceive after one year of unprotected intercourse, or after six months in women over age 35. There are multiple causes of infertility. The Center for Innovative GYN Care has been able to help women prepare for fertility treatments by resolving conditions that get in the way of conception including uterine polyps, fibroids or septum; pelvic and intrauterine adhesions; hydrosalpinx; and endometriosis. These are all conditions that have been successfully surgically treated by Dr. Paul MacKoul and Dr. Natalya Danilyants to prepare women for IVF.


Imaging tests: pelvic ultrasound, MRI, sonohysterogram, or hysterosalpingogram (HSG) can raise suspicions of polyps, fibroids, septum, or abnormal tubes. A hysterosalpingogram can evaluate whether the tubes are open and assess their overall shape.

Pelvic adhesions and endometriosis cannot be seen on imaging tests. For a definitive diagnosis, the abnormalities must be seen directly with a camera.

  • Hysteroscopy is the insertion of a small, thin, telescope-like camera into the uterus through the vagina. A hysteroscope is used to identify and treat uterine polyps, fibroids, and septum.
  • Laparoscopy is the insertion of a small, thin, telescope-like camera into the abdomen, usually through the navel. This allows for a full evaluation of the pelvis, including the uterus, tubes, and ovaries. Endometriosis, pelvic adhesions, and hydrosalpinx would all be seen through the laparoscope.

Surgical Treatment Options

Management of the conditions discussed can be accomplished hysteroscopically, laparoscopically, or through a combination of both, with techniques pioneered by Dr. Paul J. MacKoul, MD, Advanced Laparoscopic Surgeon.To learn more about CIGC minimally invasive laparoscopic procedures for helping women prepare for fertility treatment, please visit:

*Endometriosis cannot be cured, but has been successfully treated surgically in advance of IVF. Depending on the severity of endometriosis, some patients choose to have a hysterectomy, but this never a primary recommendation by a CIGC surgeon unless a woman is no longer interested in having children.