Where Does the Reproductive Endocrinology and Infertility Subspecialist Fit in the Spectrum of Gynecologic Surgeries?

Abstract

Benign gynecologic surgery is vital to health care for women in different age groups. Surgical interventions tend to fall into 1 of 2 categories. The first category comprises surgeries specifically aimed at reestablishing or maintaining female reproductive function; this is more succinctly termed fertility-sparing or reproductive surgery. The second category addresses gynecologic conditions in a definitive fashion without focusing on future fertility. Among gynecologic surgeons, the physicians who are reproductive endocrinology and infertility specialists (REIs) are highly trained to be attentive to women's future fertility needs, specifically focusing on minimizing the negative impact of surgery on female reproductive structures/organs. Optimal results during reproductive surgery can be achieved when these procedures are performed through minimally invasive gynecologic surgery (MIGS) approaches. While REIs were the pioneers of microsurgery and MIGS, significant improvement in assisted reproductive technology (ART) outcomes, inadequate surgery compensation, and cultivation of more gynecologists with special training in MIGS have led most REIs to focus primarily on ART as opposed to reproductive surgeries over the last few decades. Given this change in practice pattern, this article reviews the roles that REI subspecialists played in developing microsurgery/MIGS and where the REI specialty currently fits in the spectrum of gynecologic surgeries. (J GYNECOL SURG 20XX:000)