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Sometimes fertility problems can result from a person’s body structure (anatomy). A physical complication may be something one is born with, such as a blockage of the reproductive ducts in a man or an abnormally shaped uterine cavity in a woman. Fertility challenges can also result from conditions that develop over time, such as fibroids or scarring from endometriosis.

Physical complications can often be successfully addressed by surgical procedures. Based on the results of your fertility evaluation, the reproductive endocrinologists at RMA Long Island IVF will recommend if a surgical procedure is needed before advising fertility medication or therapy. Surgical procedures take place at our ambulatory suite in Melville or in a local hospital setting.

Primary surgical fertility treatments for women include:


Hysteroscopy is a technique that is used to diagnose or treat conditions inside of the uterus, some of which could lead to fertility issues. This outpatient procedure involves the insertion of a thin, lighted telescope device called a hysteroscope that goes through the vagina and into the uterus. The hysteroscope transmits the image of your uterus onto a screen. Hysteroscopy can detect or treat conditions such as:

  • Fibroid tumors
  • Endometrial polyps
  • Intrauterine scar tissue
  • A bicornuate uterus or septate uterine malformation
  • Other uterine issues


This operation involves making a small incision below the umbilicus and insertion of a telescope in order to view the contents and condition of your pelvic organs. If present, it is possible to treat abnormal conditions such as endometriosis, pelvic scar tissue or diseased fallopian tubes. The goal of reproductive surgery is to restore the anatomy to as normal a condition as possible or to remove or block off structures that cannot be repaired (e.g. hydrosalpinx).

D&C (dilation and curettage)

During this brief outpatient procedure, the cervix is dilated, and a curette instrument (suction aspiration) is used to remove tissue from inside the uterus.

Primary surgical fertility treatments for men include the following:

Microsurgical Epididymal Sperm Aspiration (MESA)

During a MESA procedure, a small incision is made in the scrotum. The seminal fluid (semen) is aspirated from the epididymis (duct behind the testes) using an operating microscope.

Testicular Sperm Extraction (TESE)

Microsurgical TESE requires retrieval of a small piece of testicular tissue and is usually performed in patients lacking sperm production.

Both the MESA and TESE procedures are generally performed around the time that the woman’s eggs are retrieved. They are minimally invasive with a short recovery period.

To learn more about our surgical fertility treatments, please call our offices at any time or request a consultation with one of our fertility specialists.