Serene S. Srouji, MD

About

Baltimore for medical school at Johns Hopkins (1994-1998), Seattle for obstetrics-gynecology residency at University of Washington Hospitals (1998-2002), Boston for reproductive endocrinology fellowship at Brigham and Women’s. Serene S. Srouji, MD came to the city’s fertility program from two other coasts, and she now holds the three titles inside it that decide how care is delivered: medical director of the Center for Infertility and Reproductive Surgery, medical director of its assisted reproductive technology program, and associate director for robotic surgery in reproductive endocrinology.

Those are not ceremonial roles. The medical director of a hospital fertility center is accountable for the clinical standards of the whole operation — which protocols get used, how stimulation is monitored, how the embryology laboratory and the physicians coordinate, how the program reports its outcomes. The center reports cycle results to the Society for Assisted Reproductive Technology and the Centers for Disease Control and Prevention every year, which is the only reason anyone outside the institution can compare a program’s live-birth rate and its rate of triplets-or-more against national figures. The ART program directorship sits on top of the IVF laboratory itself, a nationally certified, full-service lab that handles hormone testing, semen analysis and sperm processing, genetic testing, embryo culture and freezing in-house.

The third title is the operating room. Brigham and Women’s describes CIRS as a national leader in robotic gynecologic surgery: da Vinci procedures through 5-12 mm incisions with a three-dimensional high-definition view, tremor filtered out of the surgeon’s hand movements. This is where New England’s first successful robot-assisted laparoscopic tubal sterilization reversal was performed, in January 2007, and shortly after, in February 2007, Boston’s first robot-assisted hybrid myomectomy for very large fibroids. Srouji’s listed clinical interests — fibroids, gynecologic laparoscopic surgery, hysteroscopic surgery, robotic surgery, IVF, infertility and LGBTQ health — put her on both the operative and the cycle side of the same disease. She is certified in obstetrics and gynecology by the ABOG (recorded 2006 and 2008) and, like every physician at the center, is on the Harvard Medical School faculty.

Clinical Expertise

• Robotic and laparoscopic myomectomy: Fibroid removal that keeps the uterus, performed robotically or laparoscopically through 3-5 small incisions instead of the large abdominal incision an open myomectomy requires, with less blood loss, less pain, quicker recovery and less scar tissue — the last point being the one a fertility patient cares about, since adhesions after uterine surgery can themselves impair conception.
• Fibroid strategy, including when not to operate: Fibroids are the leading cause of hysterectomy in the United States, roughly a third of them; the center weighs hysteroscopic removal of cavity fibroids, laparoscopic or robotic myomectomy, and radiofrequency ablation (Acessa), noting that ablation’s safety in women who want pregnancy has not been demonstrated. Recurrence after myomectomy runs 25-50 percent over one to ten years, so the plan has to include what happens next.
• IVF and assisted reproduction: Stimulation, monitoring, retrieval, fertilization and day-3 or day-5 transfer, with ICSI for severe male factor or prior fertilization failure, assisted hatching for older patients and repeat implantation failure, and PGT biopsy on day 5 or day 6 with genetic counseling.
• Hysteroscopic surgery: Diagnostic and operative entry into the uterine cavity for polyps, submucosal fibroids, adhesions and malformations — the pre-transfer clean-up that determines whether an embryo can implant.
• Tubal surgery: Laparoscopic and robotic reversal of tubal ligation, a same-day procedure at the center, with success depending on age, the original ligation method and remaining tube length.
• LGBTQ health and single-patient care: The center’s stated position is that all fertility services, without exception, are open to single individuals and couples regardless of gender or sexual orientation.

Why Choose Dr. Serene S. Srouji

The person who sets the protocols also reads your scan. Being treated by the medical director of the center means the physician making your decisions is the one responsible for the standards those decisions follow.

A surgeon and a reproductive endocrinologist in the same appointment. Fibroids, adhesions, tubal disease and a uterus someone still wants to carry a pregnancy in are a single problem with two skill sets. CIRS states its surgeons are trained to minimize the effect of an operation on reproductive organs; Srouji holds the robotic surgery directorship in that program while also running ART cycles.

Access to trials, not just treatment. The center runs research programs in robotic surgery, endometriosis, IVF translation, fertility preservation and stem cells. One open example: the Thrive-IVF study of investigational drug NT100 for women aged 21-38 who have had three or more failed IVF cycles with good-quality embryos, where study procedures, medication and $1,000 toward embryo storage are provided at no cost. Institutional review and enrollment are the medical director’s world.

Historic institutional context. The Brigham and Women’s research tradition this center claims runs back to 1944, when researchers at the Free Hospital for Women first fertilized a human egg outside the body. That is the lineage of the ART program she directs.

Professional Affiliations

Medical Director, Center for Infertility and Reproductive Surgery, Brigham and Women’s Hospital; Medical Director, Assisted Reproductive Technologies Program; Associate Director for Robotic Surgery in Reproductive Endocrinology. Harvard Medical School faculty. Certified in Obstetrics and Gynecology by the American Board of Obstetrics and Gynecology (2006, re-recorded 2008). Education: Johns Hopkins University School of Medicine (MD, 1998); University of Washington Hospitals residency (1998-2002); Brigham and Women’s Hospital fellowship in reproductive endocrinology and infertility. Clinic: 75 Francis Street, Boston, with CIRS also seeing patients at Newton-Wellesley Hospital, Braintree and Foxborough.

Suitable For

• Patients with fibroids who still want to be pregnant, where the choice among hysteroscopic, laparoscopic, robotic and non-surgical management is the actual decision.
• IVF patients whose cycle is blocked by surgical disease — adhesions, a cavity-distorting fibroid, hydrosalpinx, or a prior sterilization they now want reversed.
• Anyone who wants one physician for the operation and the cycle rather than a surgical consult at one office and stimulation at another.
• Patients with repeated IVF failure who would consider a clinical trial — the Thrive-IVF protocol is the center’s current example.
• LGBTQ+ patients and single individuals entering ART at a program whose written policy is that every service is open to them.