Surgical procedures to treat infertility have changed dramatically in the past 50 years. The two main factors for the change were the introduction of in vitro fertilization (IVF) and minimally invasive surgery. As the success rates of IVF have improved since the birth of the first baby in 1978, many invasive surgical procedures to repair damaged fallopian tubes and remove endometriosis and scar tissue were replaced by the less invasive IVF. Surgeries for severe endometriosis and scar tissue that required open abdominal approach with large incisions were replaced by outpatient laparoscopic approach that involved smaller incisions and faster recovery.
One notable example is surgery to repair damaged fallopian tubes. In the past, a large incision was required to enter the abdomen. Hours of delicate surgery involving the microscope were needed to reconstruct the damage. The results in terms of pregnancies and live births were generally disappointing and such surgeries required hospitalization and long recovery and disability. Today, repair of damaged tubes is performed infrequently, even with the availability of robotic and single site outpatient laparoscopic surgery. Damaged fallopian tubes are either left untreated or removed surgically to optimize the results of IVF.