I often encounter patients who ask, “I want to get pregnant, why do I need surgery?” “I want to go straight to IVF, why do I need surgery?” “Can I do it without surgery?” For our dear friends who are eager to become “parents”, some surgical treatment is necessary. The following is a detailed discussion of six common types of infertility that require surgery. The fallopian tube is the “channel” for the union of sperm and egg, and many infertile women are prone to fallopian tube and pelvic inflammatory disease due to their experience of “abortion, medical abortion, IUD and IUD removal”. Among the infertility factors, the pelvic tubal factor accounts for 40~50%. Fallopian tube imaging is the most common method of tubal examination. If tubal incompetence, hydrosalpinx, pelvic adhesions, etc. are found, laparoscopic surgery can clarify the specific pelvic lesions and restore the “original” pelvic cavity as much as possible; unblock the fallopian tubes, actively try to conceive after surgery, and if necessary, perform ovulation treatment to increase the chance of pregnancy; or further seek “For those with moderate to severe hydrosalpinx, the function of the fallopian tubes is often severely damaged and IVF is a cost-effective treatment option. Laparoscopic treatment of hydrosalpinx before conception will significantly improve the pregnancy rate. Endometriosis is a common cause of dysmenorrhea in many women with infertility, but about 50% of endometriosis patients have dysmenorrhea. 40% of endometriosis patients have infertility in combination. More than 40% of patients with endometriosis have combined infertility. Laparoscopic surgery is the gold standard for diagnosing “endometriosis” and also for removing as many lesions as possible, relieving symptoms, improving the reproductive “internal environment” and increasing the chances of pregnancy. ”Ovarian chocolate cysts are the most common form of endometriosis. If the cyst is larger than 5 cm, surgery is required, because the special characteristics of ovarian chocolate cyst removal make the surgery more difficult and prone to recurrence after surgery. Therefore, it is wise to remind such patients to choose a more specialized surgeon to perform such surgery. Uterine fibroids are more common in women of childbearing age, and the location and size of fibroids are closely related to pregnancy. Fibroids that grow close to the lining of the uterine cavity, such as submucosal fibroids and larger fibroids that directly affect the endometrium, should be treated surgically. The surgery can be laparoscopic, hysteroscopic or a combination of both. 4. polycystic ovary syndrome Many women with infertility have irregular menstruation, mostly manifesting as prolonged menstrual cycles or even absence of menstruation for several months. Most of these patients have polycystic ovary syndrome, which is often associated with sporadic ovulation or non-ovulation and leads to infertility. Ovarian perforation is only a second-line treatment option for these patients, and it is not recommended because the damage caused by the surgery may lead to the decline of ovarian function. However, for patients who are resistant to ovulation-promoting drugs and have a strong need for natural pregnancy, surgery can be considered and after surgery, natural ovulation can be restored or ovulation-promoting treatment can be performed to obtain a natural pregnancy. 5. Unexplained infertility There are many patients who say that they have done many tests and have been seeking medical help for years without knowing the reason for not getting pregnant. Many patients have endometriosis and uterine cavity abnormality at the same time. Therefore, hysteroscopy is necessary for this type of patients. 6, cavity lesions The uterine cavity is the place where the “baby” “sleeps”. If there are polyps, longitudinal septum, etc., or if there have been surgical operations such as abortion or IUI that cause cavity adhesions, pregnancy will be affected. This “soil” is crucial, and hysteroscopy is able to see the uterine cavity directly and treat the lesions, so many patients with infertility need hysteroscopy.