This chapter describes the surgery before assisted reproductive technology. The success rates in in-vitro fertilization (IVF) treatment are dependent on many factors. Amongst these the most important of course remains an assessment of the couple and the initial consultation. The pretreatment scan is imperative to look for surgically correctable causes which if treated adequately will positively influence the final outcome of the treatment which is a live birth. This chapter looks at the different structural and organic causes and the pathophysiology where a surgical intervention before the treatment should be discussed and offered to the patient with appropriate counseling. The common conditions, treatment options and implications in relation to assisted reproductive technology (ART) and divide them into the three sections following as the tubes, the ovaries, and the uterus.