Yeung, P. (2025). Surgery in Restorative Reproductive Medicine. Journal of Restorative Reproductive Medicine, 1, 1-4. https://doi.org/10.63264/v8yt9r80
Yeung P. Surgery in Restorative Reproductive Medicine. J Restorative Reprod Med. 2025;1:1-4. doi:10.63264/v8yt9r80
Yeung, Patrick. "Surgery in Restorative Reproductive Medicine." Journal of Restorative Reproductive Medicine, vol. 1, 2025, pp. 1-4.
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Restorative surgery aims to remove endometriosis and protect fertility
A surgeon at an endometriosis center wrote this invited commentary on restorative surgery. His center reported repeat surgery in under 3% of patients within 10 years. In his group's pilot study, up to 67% got pregnant over the long term, including women with an ovarian endometrioma.
Key Findings
The paper defines restorative reproductive surgery as all procedures that aim to relieve symptoms while restoring the function of reproductive organs.
The author's pilot study reported long-term pregnancy in up to 67%, including patients who had an ovarian endometrioma larger than 3 cm.
A second study from the author's center reported repeat surgery in under 3% in 10 years, and those patients took no long-term hormonal suppression after surgery.
The paper states that roughly 1 woman in 10 without symptoms has endometriosis, as do 50% of women with infertility and no pelvic pain.
The paper states that repeat surgery after ablation runs between 40-60%, citing two earlier studies.
Interpretation
The paper is an invited narrative commentary by one surgeon, and the author says it is not a systematic review. Both outcome studies come from the author's own group. The repeat surgery figure comes from a single tertiary referral center. The commentary summarizes each study in one or two sentences. The author calls for more resources, training and research.
RRM Context
Restorative reproductive medicine looks for the condition underneath a reproductive problem. The commentary gives surgery that job for pelvic anatomy. The author says ART often bypasses organ disease. He says ablation does not fully remove implants. The paper also lists procedures for the tubes, ovaries and uterus, and varicocele surgery for the male partner.
Our editorial summary of this paper, not the article's abstract.
Abstract
Restorative reproductive surgery has emerged to become an exciting and promising field of surgery that can transform the way that we treat patients, especially regarding fertility. As a prime example of this type of surgery, restorative reproductive surgery for endometriosis, a common and debilitating disease that can lead to infertility and pelvic pain, offers a root cause treatment to remove the actual disease and to optimize the reproductive anatomy, for best patient outcomes. Optimal excision of endometriosis and prevention of pelvic adhesions has been shown to lead to reduce symptoms, to lead to high natural fertility rates, and to lead to very low rates of the need for repeat surgery. Patients have improved symptoms and quality of life, in addition to improved fertility chances for one and subsequent pregnancies (if desired), demonstrating the link between wellness and fertility. There is an urgent need for more resources, training, advocacy, research and publication for this exciting area of restorative reproductive surgery. Its time has come.
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