641: DEBATE - Bowel Resection Versus IVF in the Infertile Patient With Rectosigmoid Nodule

Monday, November 16, 2026
3:30 pm - 4:30 pm

Room: 302

Chair: John Preston Parry

Faculty: Sarah Choi, Tommaso Falcone

Description: Surgical intervention in patients with meaningful endometriosis is often logical and appropriate. Yet procreative balances sometimes push patient management in directions we might not choose for ourselves or that can be counter intuitive. This debate will pit surgical REI's against CBG's for balancing IVF and surgical balances in maximizing fertility. Moreover, the side taken by speakers will be randomized so that they have to be prepared to speak on either side (and will be allowed a brief self-rebuttal at the end). Evidence based medicine fused with nuance will be the emphasis, seasoned with friendly rivalry and humor in this debate on bowel resection versus IVF in the infertile patient with a rectosigmoid nodule.

Learning Objectives: At the end of this course, the participant will be able to: 1) Evaluate the mechanisms by which bowel resection for rectosigmoid endometriosis may improve fertility outcomes beyond those achievable with in vitro fertilization (IVF), including restoration of pelvic anatomy, reduction of inflammatory burden, and alleviation of pain-related factors affecting conception; 2) Assess the advantages of IVF in infertile patients with rectosigmoid nodules, including avoidance of surgical morbidity, reduced time to conception in selected patients, and the ability to overcome fertility barriers that may persist despite surgical intervention; and 3) Apply patient-centered and evidence-based principles to balance surgical and assisted reproductive approaches when counseling infertile patients with rectosigmoid endometriosis, incorporating disease characteristics, reproductive goals, symptom burden, ovarian reserve, and treatment-related risks and benefits.

Course Outline

3:45 PM Welcome, Introduction and Course Overview

J. Parry

3:50 PM Bowel Resection

S. Choi

4:00 PM IVF in the Infertile Patient With Rectosigmoid Nodule
T. Falcone

4:10 PM Discussion Questions & Answers

4:45 PM Adjourn