Occasionally, surgery is indicated to correct anatomic obstacles to fertility. These surgical procedures are performed at The Woman’s Hospital of Texas, Fannin Surgicare (an outpatient surgical facility on The Woman’s Hospital of Texas campus), or one of several other Houston-area hospitals.


Fibroids, or uterine myomas, are ball-like growths of the uterine muscle that occur commonly. If these fibroids are too large or interfere with the uterine cavity, they should be removed surgically. The surgical approach—open abdominal surgery, laparoscopy through small incisions in the abdomen (with or without the DaVinci robot), or hysteroscopy through the woman’s cervix—depends on the number, size, and location of the fibroids. Your physician will discuss the range of surgical approaches and options for you based on your particular anatomy.

Operative Hysteroscopy

Hysteroscopy is the process of inserting a camera into the uterine cavity through the cervix. By itself, it is an outpatient procedure that usually performed at the outpatient surgery center. Hysteroscopy can be used to remove polyps (overgrowth of the uterine lining), fibroids, or scar tissue that can be found in the uterine cavity and limit the chance for successful pregnancy. Some women are born with abnormalities in the shape of their uterus which can also be repaired through hysteroscopy.

Tubal Surgery

The fallopian tubes transport sperm to the egg, serve as the location of egg fertilization, and then facilitate movement of the embryo back to the uterus. Abnormalities in the fallopian tubes can arise from previous infection, surgery, or other causes. In some cases tubal blockage can be corrected surgically. In other cases, damaged tubes cannot be repaired but must be removed or artificially blocked as fluid from these diseased tubes can decrease the success of the IVF that is required in the setting of non-functioning tubes.


Laparoscopy is a minimally invasive surgical technique used to diagnose and manage conditions involving the reproductive organs in the pelvis. Sometimes, a surgical approach is the only way to accurately diagnose and treat conditions that impair fertility. When surgery is required, a laparoscopic surgical approach is frequently used because it offers excellent visualization of the anatomy for the surgeon. Laparoscopic surgeries benefit the patient as well as they are usually performed on an outpatient basis. Patients go home the same day and can expect a quick recovery. Laparoscopy sometimes utilizes the DaVinci robot, which enables a laparoscopic approach for surgeries that may otherwise require an “open” or abdominal approach through a large incision. Dr. Kovanci is certified to perform DaVinci-assisted laparoscopy. Speak with him about the benefits of this technology.