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Epidaurus · Treatment Guide · Reproductive Services

Going abroad for —

Fertility Surgery Quality

Surgical fertility treatments including tubal reversal, varicocele repair, etc.

A fuller editorial guide to fertility surgery quality is coming soon. For now, the ranking below compares every country we have assessed on it — open a country's report for the cited detail behind its score.

The country comparison

Which countries are best for fertility surgery quality

The destinations ranked high→low under this lens — each with the reasoning behind its score, the cited evidence one click down, and its full report. The verdict is free; the report is the depth.

19 / 19 Countries ranked

Researched and assessed by the Epidaurus editorial pipeline against our published scale. A country below the rule is not yet assessed enough — never ranked last.

  1. 1 United Kingdom GB 4.5/5 Good The United Kingdom demonstrates exceptional fertility surgery quality with most attributes of a score 5: multiple internationally accredited facilities (107 HFEA clinics, 83 BSGE endometriosis centres), fellowship-tra... Full report
    The evidence behind this score 5 cited points
    • At least 12 RCOG-recognised Reproductive Medicine subspecialty training centres producing fellowship-trained surgeons with mandatory OSATS competency assessments
    • 83 BSGE-Accredited Endometriosis Centres with national database outcome tracking published in peer-reviewed journals
    • Tubal reversal success rates 70-80% for women under 35 and laparoscopic ovarian drilling live birth rate 61%, both exceeding international benchmarks
    • Robotic surgery (da Vinci X) now routine at specialist centres (e.g. CEMIG); 3D laparoscopy and operative hysteroscopy widely deployed; micro-TESE available at multiple London centres
    • HFEA inspection programme found 35% of clinics with zero non-compliances and >99% of 100,000+ annual cycles without incident; integrated care pathways with NICE 2024 endometriosis-fertility pathway and BFS policy coordination

    Read the full United Kingdom report →

  2. 2 Japan JP 4.5/5 Good Japan demonstrates world-class surgical expertise with 800+ JSGOE-certified laparoscopic surgeons, multiple JCI-accredited facilities, and published success rates exceeding international benchmarks (varicocele >70%, e... Full report
    The evidence behind this score 5 cited points
    • 800+ JSGOE-certified laparoscopic surgeons across 260+ training facilities, plus 47+ board-certified male infertility specialists performing 2,394+ surgeries annually
    • Varicocele surgery success rate >70% confirmed pregnancy; endometriosis laparoscopy 68.24% pregnancy rate; vasovasostomy patency 81.8%—all exceeding international benchmarks
    • 180+ da Vinci robotic systems and domestic hinotori™ platform; mandatory JSGOE complication reporting system since 2014; Japan Oncofertility Registry tracking 9,491 cases
    • University of Osaka's integrated surgical-ART reproductive medicine centre with 625 registered ART facilities nationwide (561,664 treatment cycles in 2023)
    • Red flags: 2025 survey shows facilities reluctant to publicly disclose success rates; language barrier cited as 'commonly cited challenge' at majority of clinics; regulatory restrictions on LGBTQ+ and unmarried patients

    Read the full Japan report →

  3. 3 South Korea KR 4.5/5 Good South Korea demonstrates excellent fertility surgery quality at major centers with 19+ specialists at leading facilities, multiple JCI and KAHF-accredited hospitals, and exceptional surgical outcomes including 78.6% p... Full report
    The evidence behind this score 7 cited points
    • CHA Fertility Center has 19 specialists in obstetrics, gynecology, urology specializing in infertility with 50+ researchers, exceeding the 10+ fellowship-trained reproductive surgeons criterion for Score 5
    • Multiple JCI-accredited facilities (Yonsei Severance, Gangnam Severance, MizMedi) and KAHF-accredited centers (CHA Fertility Center twice consecutively) with dedicated reproductive surgery programs
    • Robotic myomectomy demonstrates 78.6% spontaneous pregnancy rate, with one center achieving 1,000 robotic myomectomy cases by 2019; myomectomy mortality rate of 0.013% significantly lower than international averages
    • Varicocele repair success rates of 60-80% semen parameter improvement and 26-37% spontaneous pregnancy rates exceed international benchmarks
    • Advanced surgical technology including da Vinci robotic systems (15,000+ cases at Yonsei), Korean Revo-i robotic system, microsurgery, and AI time-lapse embryo monitoring systems
    • Consultation and procedure wait times under 1 week, substantially exceeding Score 5 threshold of <4 weeks for consultations and <8 weeks for procedures
    • Multilingual international patient coordinators (English, Russian, Chinese, Japanese, Arabic), VIP rooms for international patients, 71-clinic international network, and airport-to-hospital access infrastructure

    Read the full South Korea report →

  4. 4 United States US 4.5/5 Good The United States demonstrates exceptionally high fertility surgery quality with approximately 1,250 fellowship-trained reproductive specialists completing rigorous ACGME-accredited training, state-of-the-art surgical... Full report
    The evidence behind this score 9 cited points
    • Approximately 1,250 active REI subspecialists, all completing rigorous seven-year post-MD fellowship training with comprehensive reproductive surgery education including robotic-assisted and microsurgical techniques
    • Tubal reversal pregnancy rates of 70-80% for women under 35 with patency rates of 85-95%, exceeding international benchmarks
    • Varicocele repair achieving 70% pregnancy rates with sperm improvements averaging 12 million/mL count increase and 11% motility improvement
    • Micro-TESE sperm retrieval rates of 40-73% for non-obstructive azoospermia, with first-time procedures achieving 64.6% success
    • 643 fertility clinics with 49 ACGME-accredited fellowship programs, multiple accreditations including Joint Commission, CAP, CLIA, AIUM
    • Widespread availability of robotic surgical systems, advanced three-dimensional laparoscopy, microsurgery with operating microscopes
    • Exemplary multidisciplinary surgical teams integrating reproductive surgeons, reproductive endocrinologists, urologists, and specialists in other disciplines
    • SART registry participation with transparent outcome reporting and annual clinic rankings by Newsweek/Statista incorporating quality metrics
    • Report explicitly notes 'no equivalent national database exists specifically for fertility surgery outcomes' and 'most US fertility centers do not have established international patient departments'

    Read the full United States report →

  5. 5 Turkey TR 4.5/5 Good Turkey meets all Score 4 criteria with multiple JCI-accredited facilities, qualified reproductive surgeons with strong international training, published success rates at international standards, comprehensive advanced... Full report
    The evidence behind this score 8 cited points
    • Multiple JCI-accredited flagship facilities (Memorial designated as Turkey's only Ministry of Health accredited IVF training facility; Acibadem, Liv, Anadolu, Medipol all JCI-accredited) with dedicated reproductive surgery programs
    • Internationally trained reproductive surgeons: Prof. Semra Kahraman (Weill Cornell, 40+ years), Prof. Bülent Tıraş (~6,000 ART cycles/year at Acibadem), Prof. Önder Koç (multidisciplinary endometriosis team), Assoc. Prof. Korkmaz (tubal microsurgery), Assoc. Prof. Demirbaş (varicocele/micro-TESE specialist)
    • Documented success rates: tubal reversal pregnancy rates 40-80%; endometriosis natural conception 41.9-50% at 1 year; varicocele repair 60-70% semen improvement; IVF clinical pregnancy rates ~50% higher than US averages
    • Comprehensive advanced surgical technology: laparoscopic systems, operative hysteroscopy, microsurgical microscopes, robotic myomectomy, 3D intraoperative imaging, hybrid operating theatres
    • Systematic Ministry of Health oversight: bi-annual inspections of all fertility clinics, IVF physician certification requirements, ISO 15189 accreditation at selected labs; TSRM active engagement with ASRM and publication of PGT-M guidelines in PubMed
    • Vertically integrated multidisciplinary reproductive care with seamless surgical-to-ART pathways and case manager coordination
    • Exceptional access: no waiting lists at major centres, consultations within days, procedures within weeks; 50-70% cost savings below Western European prices
    • Material limitation: explicit absence of public outcomes registry; outcome data clinic-reported rather than independently audited, limiting comparative transparency

    Read the full Turkey report →

  6. 6 Israel IL 4.5/5 Good Israel exceeds all Score 4 criteria and meets most Score 5 criteria. The country demonstrates 10+ fellowship-trained reproductive surgeons across four JCI-accredited centers with documented high case volumes driven by... Full report
    The evidence behind this score 9 cited points
    • At least 10 documented fellowship-trained reproductive surgeons across major centers, including Dr. Soriano (Sheba, Forbes 2021 best doctors), Dr. Goldenberg (Golden Hysteroscope Award, ~100 publications), and Dr. Madgar (male microsurgery specialist trained in Barcelona, Sheba since 1996)
    • Four JCI-accredited hospitals with dedicated reproductive surgery programs: Assuta (2011, 2014), Sheba (largest hospital in Israel, ranked among world's best by Newsweek for 7 consecutive years), Rambam (since 2016, 95% success rate in 200+ robotic procedures), and Ichilov
    • Published success rates exceeding benchmarks: 42% delivery rate for laparoscopic endometriosis excision in severe cases with repeated IVF failures (Fertility and Sterility 2016), ~50% overall pregnancy rate after laparoscopic fertility procedures, 65% IVF success rate vs 40% global average
    • Comprehensive advanced surgical technology: Da Vinci Xi robotic systems at Ichilov, Hadassah, and Rambam; microsurgical capabilities for TESE/MESA/PESA at Sheba and Assuta; advanced operative hysteroscopy and laparoscopy universally available
    • Systematic quality assurance: Ministry of Health regulation of all fertility units, 2024 State Comptroller regulatory review, JCI accreditation mandates for internal audit and peer review, outcome data aggregated by Ministry and Israeli Society of Reproductive Medicine, active publication in peer-reviewed international journals
    • Seamless integrated care: Sheba's multidisciplinary endometriosis center with 14 specialists treating ~70 patients weekly, Ichilov Reproductive Research Institute since 1975, direct transition pathways from surgical treatment to IVF at same institution
    • Mature international patient services: Dedicated medical tourism departments at Sheba, Hadassah, Ichilov, and Rambam with multilingual coordinators, fast-track scheduling, VAT exemptions, logistics support, treating 1,000+ international patients annually
    • Rapid access times: Ichilov explicitly advertises 'treatment without queues' with rapid scheduling for international patients
    • Israel's world-leading case volume: 5,311 IVF cycles per million population (highest globally), creating exceptional procedural experience for fertility surgeons

    Read the full Israel report →

  7. 7 Singapore SG 4.5/5 Good Singapore demonstrates exceptional fertility surgery quality with more than a dozen fellowship-trained reproductive surgeons, multiple internationally accredited facilities (KKH APAGE-accredited, Mount Elizabeth/NUH/G... Full report
    The evidence behind this score 4 cited points
    • Surgeon expertise: >12 fellowship-trained reproductive surgeons including Dr. Ma Li (>1,500 stage IV endometriosis surgeries), Dr. Charles Koh (pioneer of laparoscopic tubal microsurgery with Distinguished Surgeon Award 2009), Dr. Suresh Nair (robotic surgery pioneer)
    • Accreditation: KKH APAGE-accredited since 2016 with 50 international fellows trained; Mount Elizabeth/NUH/Gleneagles JCI-accredited; Raffles/Thomson RTAC-accredited
    • Success rates: Laparoscopic tubal reanastomosis 75% pregnancy rate/58.3% live birth rate; endometriosis excision 80-85% conception rates (stages I-II), 70-75% (stage III), 50-60% (stage IV); sperm retrieval >90% success for obstructive azoospermia; ectopic pregnancy laparoscopic management 96-99%
    • Technology and infrastructure: 7 da Vinci robotic systems at Mount Elizabeth Novena; comprehensive microsurgical capabilities; 24-hour Level 3 laparoscopic emergency surgeon on-call at KKH; 646,000 international patients in 2024; English-language care and dedicated international patient departments at major hospitals

    Read the full Singapore report →

  8. 8 Spain ES 4.5/5 Good Spain demonstrates world-class fertility surgery infrastructure with 10+ reproductive surgeons across major centers, multiple JCI-accredited hospitals, and published success rates exceeding international benchmarks (t... Full report
    The evidence behind this score 4 cited points
    • Surgical expertise: IVI RMA employs reproductive surgeons across 31 Spanish clinics and performs >22,000 treatments annually; Dexeus Mujer operates dedicated Endometriosis Unit; Fundació Puigvert's Andrology Service co-founded the International Society of Andrology in 1970
    • Success rates: Tubal reversal pregnancy rate 55% overall and >70% in women under age 35 at Clínica Universidad de Navarra; endometriosis cystectomy 92.6% positive fetal heart rate at 6 weeks vs 79.4% untreated (Hospital La Paz, n=244); varicocele microsurgery 67% sperm production improvement
    • Technology & accreditation: PlasmaJet ablation at Dexeus (first in Spain, 2018), da Vinci robotic systems at major hospitals, multiple JCI-accredited facilities including Clínica Universidad de Navarra (continuous since 2004, 8th reaccreditation 2026), Centro Médico Teknon (Forbes top-10 hospital Spain 2024)
    • International infrastructure: >55% of patients at flagship clinics are international (135+ nationalities); multilingual coordinators; 24/7 support; 1-4 weeks to consultation, 4-8 weeks to surgical scheduling; mandatory SEF national registry with annual outcome reporting

    Read the full Spain report →

  9. 9 Thailand TH 4.0/5 Good Thailand demonstrates good fertility surgery quality with multiple JCI-accredited facilities, experienced reproductive specialists, advanced surgical technology including robotic systems, and success rates meeting int... Full report
    The evidence behind this score 7 cited points
    • Multiple JCI-accredited facilities including Bangkok Hospital, Bumrungrad, Samitivej, and Vejthani offering comprehensive fertility surgery services
    • Tubal reversal pregnancy rates of 50-80% meeting or exceeding international benchmarks of 45-60%
    • Advanced surgical technology including da Vinci robotic systems and microsurgical equipment at major centers
    • Bumrungrad Fertility Center with 20+ fertility specialists; Vejthani surgeon with 13+ years experience and 10,000+ laparoscopic cases
    • Integrated multidisciplinary care combining fertility surgery with IVF, ICSI, and genetic testing
    • Excellent international patient services with no waiting lists, multiple language support, and comprehensive coordinators
    • Limited public outcome data and no national registries for fertility surgery outcomes restricting Score 5 rating

    Read the full Thailand report →

  10. 10 Jordan JO 4.0/5 Good Jordan demonstrates good fertility surgery quality anchored in internationally trained reproductive surgeons (FRCOG, MRCOG, McGill REI, Oxford NHS credentials) practicing in JCI-accredited facilities with published ou... Full report
    The evidence behind this score 5 cited points
    • Five fellowship-trained reproductive surgeons documented with international credentials: Dr. Sharif (FRCOG/FACOG/Birmingham fellowship), Dr. Alkhaledi (McGill REI), Dr. El-Zibdeh (MRCOG/Oxford NHS), Dr. Dabit (Vienna FACHARZT), Dr. Albattat (Birmingham training)
    • Multiple JCI-accredited facilities: Jordan Hospital (JCI/HCAC/ISO 9001), Abdali Hospital (second consecutive JCI accreditation, November 2025 with special commendations for quality and facility management), Specialty Hospital (25+ years dedicated fertility center with dedicated OR suites)
    • Published hysteroscopic surgery outcomes: 47.9% overall pregnancy rate, 27.9% spontaneous conception rate, minimal complications (n=165, Jordan University Hospital and Al-Noor Fertility Centre, 2016–2021) meeting the 45–60% pregnancy rate benchmark
    • Full suite of advanced minimally invasive surgery available: laparoscopic myomectomy/endometriosis excision, hysteroscopic procedures, microscopic sperm extraction and micro/laparoscopic varicocele repair (Abdali), sperm aspiration techniques MESA/TESE/PESA/FNA (Specialty)
    • Strong medical tourism infrastructure: 224,000 international medical patients in 2024, well-established international patient coordinators, English-language services, medical tourism packages with 50–75% cost savings versus US/European pricing

    Read the full Jordan report →

  11. 11 Colombia CO 4.0/5 Good Colombia meets the criteria for Score 4 (Good) with 15+ fertility specialists at flagship centers exceeding the 5-9 requirement, multiple internationally accredited facilities (JCI Gold Seal, REDLARA Gold Seal, ISO 90... Full report
    The evidence behind this score 4 cited points
    • Inser flagship center: 15+ fertility specialists with international training (Yale, Strasbourg), JCI Gold Seal, REDLARA Gold Seal since 2000, 30+ years experience with 20,000+ families assisted
    • Multiple accredited facilities: Inser (JCI/REDLARA/AAAASF), Reprotec (ISO 9001), Hospital Pablo Tobón Uribe (JCI), Clínica del Country (JCI) offering comprehensive fertility surgery services
    • Success rates: Tubal recanalization 40-60% pregnancy rates within one year, laparoscopic deep endometriosis excision ~5% complication rate in published 167-patient Colombian cohort
    • International patient services: 20,000+ medical tourists in 2024, no waiting lists, bilingual care, telemedicine follow-up, systematic continuity protocols

    Read the full Colombia report →

  12. 12 Germany DE 4.0/5 Good Germany demonstrates strong fertility surgery quality with multiple qualified reproductive surgeons, several internationally accredited facilities, published procedure-specific success rates meeting international stan... Full report
    The evidence behind this score 7 cited points
    • DGRM approximately 500 members across reproductive surgery subspecialties; Prof. Dr. Christian Thaler (LMU Munich director, DGRM president) Focus-ranked among top German doctors in reproductive medicine
    • QS ENDO Pilot study across 44 certified DACH-region centers: 81.6% complete endometriosis resection with 0.9% revision-requiring complications
    • Varicocelectomy outcomes: <0.8% recurrence rate with ~80% testosterone improvement (100-140 ng/ml increase), consistent with 60-80% international benchmark; TESE success rate up to 70%
    • Advanced surgical technology: Da Vinci SP single-port system deployed December 2024 (first in German-speaking countries); da Vinci X/Xi systems at multiple centers; microsurgical suites for andrology at Munich-Planegg, Meoclinic Berlin
    • EuroEndoCert tiered certification system for endometriosis centers with mandatory annual case statistics and biennial renewal; DGGG/DGRM S2k guidelines mandate pre-ART surgical interventions
    • Private fertility clinics offer surgery dates within 2 weeks via medical tourism networks (BookingHealth, DMU Medical); English/Russian-speaking international patient coordinators at Fertility Center Berlin, Asklepios, Helios networks
    • Systemic gap: No centralized surgical outcomes registry for fertility procedures (unlike D.I.R. for ART); certification voluntary; decentralized structure (75% private centers) creates variable quality

    Read the full Germany report →

  13. 13 Hungary HU 4.0/5 Good Hungary demonstrates good fertility surgery quality with notable strengths in endometriosis expertise (Semmelweis University ranks 3rd in Europe with 200+ complex procedures annually) and published success rates (81.3... Full report
    The evidence behind this score 5 cited points
    • Semmelweis University Endometriosis Center is the 3rd largest in Europe, performing 200+ complex procedures annually with documented international leadership
    • Robert Karoly/University of Pécs study reports 81.3% cumulative pregnancy rate and 94.2% live birth rate following hysterolaparoscopy, exceeding international benchmarks
    • Versys Clinics holds ESHRE ARTCC accreditation (one of four worldwide) with ISO 9001 certification; MEDEND performs 1,000+ gynaecological procedures annually; Wáberer performed 400+ procedures in 2023 alone
    • Da Vinci Xi robotic system at Semmelweis (since December 2023) and da Vinci X at Wáberer Medical Center, plus 4K laparoscopy and modern hysteroscopic equipment widely available
    • Versys Clinics operates Versys International Infertility Network for international patient coordination; Semmelweis Endometriosis Center treats 2,500 patients annually with 15% from outside Hungary

    Read the full Hungary report →

  14. 14 India IN 4.0/5 Good India demonstrates comprehensive fertility surgery capabilities that clearly exceed Score 4 criteria. The country has multiple internationally accredited facilities (54 JCI-accredited hospitals), achievement of succes... Full report
    The evidence behind this score 7 cited points
    • 54 JCI-accredited hospitals with fertility surgery programs; Apollo, Rainbow, and other major centers offering comprehensive services
    • Tubal reversal success rates of 95% for laparoscopic procedures and 90% for women under 35, exceeding international benchmarks (Score 5: >60%)
    • Micro-TESE sperm retrieval rate of 72.7% at high end of global 30-70% range, with 60% sperm detection rate
    • Dr. Jay Mehta's team operating on 2,500+ endometriosis cases annually; World Laparoscopy Hospital training thousands of surgeons annually
    • Advanced surgical technology including robotic-assisted procedures for tubal reanastomosis, myomectomy, endometriosis treatment, and ovarian transposition
    • Rapid access with no wait lists—patients undergo surgery next day and discharge next morning; IVF costs $3,000-5,000 vs $12,000-15,000 in Western nations
    • Robust international patient services with multilingual support, accommodation assistance, visa coordination, and psychological counseling

    Read the full India report →

  15. 15 United Arab Emirates AE 4.0/5 Good The UAE demonstrates surgical expertise and facilities exceeding Score 4 thresholds, with multiple fellowship-trained reproductive surgeons holding world-class credentials (15+ documented specialists), multiple JCI-ac... Full report
    The evidence behind this score 5 cited points
    • Multiple fellowship-trained reproductive surgeons including world-first Master Surgeon in Multidisciplinary Endometriosis Care (Dr. Shiva Harikrishnan, FRCOG/FACS/FACOG); 13+ consultant gynecologists at Emirates Hospitals Group; 15+ total identified specialists with Western training and dual-board credentials
    • Network of 10+ JCI-accredited fertility centers (UAE has 214 JCI-accredited facilities globally—highest count); Cleveland Clinic Abu Dhabi, American Hospital Dubai, ART Fertility Clinics, Mediclinic, Bourn Hall, Orchid Fertility, and others offering integrated surgical and ART services
    • Advanced surgical technology: RoboticScope-assisted microsurgical varicocelectomy, robotic-assisted myomectomy (UAE first), Micro-TESE with high-power operating microscopes, comprehensive laparoscopic and hysteroscopic suites with minimally invasive capabilities
    • Abu Dhabi IVF success rate exceeded 51% in 2025 (global top tier); ART Fertility reports 71% pregnancy success rate; internal quality tracking through Abu Dhabi Rewarding Exceptional Quality programme and DHA Standards for Fertility Centers, but procedure-specific surgical outcome data not published publicly
    • Exceptional medical tourism infrastructure: consultations <1 week, procedures scheduled 2-4 weeks (exceeding Score 5 benchmarks); multilingual coordinators, concierge services, luxury accommodation partnerships; legal restriction to married heterosexual couples using own genetic material limits appeal for broader international patient segments

    Read the full United Arab Emirates report →

  16. 16 Mexico MX 4.0/5 Good Mexico meets the Good (Score 4) range with multiple qualified reproductive surgeons, several internationally accredited facilities, and published success rates meeting international standards for fertility surgery. Th... Full report
    The evidence behind this score 5 cited points
    • Multiple JCI-accredited facilities including Hospital CIMA Monterrey, Médica Sur Mexico City, and International Institute for Metabolic Surgery in Tijuana serving as Medtronic training center
    • Tubal reversal pregnancy rates of 40-80% depending on patient age, with rates of 60-80% for women under 35 years old, meeting or exceeding Score 4 threshold of 45-60%
    • EndoGlobal Group in Tijuana reports 4,000+ complex endometriosis surgeries with documented patient pregnancies following advanced laparoscopic excision
    • Multiple surgeons identified with advanced subspecialty training including fellowship-trained endometriosis specialists, board-certified reproductive surgeons, and surgeons with 25+ years of experience performing 100+ procedures annually
    • Strong integration between surgical services and IVF programs at major centers with documented coordination of surgical sperm retrieval with ART cycles

    Read the full Mexico report →

  17. 17 Poland PL 4.0/5 Good Poland meets Good (Score 4) criteria with multiple qualified reproductive surgeons, internationally accredited facilities (JCI, ESHRE, ISO), modern surgical technology including 77 hospitals with robotic programs, and... Full report
    The evidence behind this score 6 cited points
    • Surgical expertise: Gyncentrum's EBU-certified urologists (500+ TESE procedures), KCM Clinic's Dr. Kucharski (800+ laparoscopic procedures, 2,000+ endometriosis cases), Medicover's multiple da Vinci-certified surgeons
    • Facility accreditation: Medicover Hospital JCI accreditation with 2,000+ da Vinci procedures since 2018; INVICTA ISO 9001/ISO 14001 certified; Artvimed ESHRE certified; 77 Polish hospitals with 224 certified robotic surgeons (2024)
    • Success rates: TESE 40–60% sperm retrieval in non-obstructive azoospermia (matches international benchmarks), endometriosis 85–90% symptom relief, myomectomy 85–95% success with 1–5% complication rates
    • Technology: Widespread access to 3D laparoscopy, robotic systems, PlasmaJet, and microsurgery (Zeiss) across multiple centers; 71% year-on-year growth in robotic gynaecological procedures
    • International patient services: ~700 international patients annually at KCM alone; multilingual coordinators (English, Italian, Russian, German, Czech, Ukrainian); assigned case managers through treatment and post-return; recognized by international insurers (BUPA, Allianz)
    • Limitation: No mandatory national outcome registry for fertility surgery; limited published data for tubal reversal and varicocele repair at Polish centers

    Read the full Poland report →

  18. 18 Malaysia MY 3.5/5 Moderate Malaysia has strong facility infrastructure with five RTAC-certified fertility centers, JCI and MSQH accreditation at major hospitals, and modern surgical technology including 3D laparoscopy, SILS, VNOTES, and micro-T... Full report
    The evidence behind this score 5 cited points
    • Five RTAC-certified fertility centers: Thomson Fertility, Alpha IVF, KL Fertility Centre, Sunway Fertility Centre, Monash IVF KPJ Johor
    • JCI Gold Seal accreditation at Sunway Medical Centre (ranked #1 hospital in Malaysia by Newsweek 2025) and Island Hospital Penang; MSQH accreditation across 123 hospitals
    • Advanced surgical technology available: 3D laparoscopy (first in Malaysia), SILS, VNOTES, HIFU, micro-TESE with 16-25× magnification
    • No published procedure-specific surgical outcome data (tubal reversal patency/pregnancy rates, varicocele sperm improvement rates) — acknowledged as significant gap relative to leading international destinations
    • Strong integration with ART programs and excellent wait times (consultations 1-2 weeks, treatment start 2-3 weeks); dedicated international patient services at major centers

    Read the full Malaysia report →

  19. 19 Brazil BR 3.5/5 Moderate Brazil demonstrates excellent male reproductive microsurgery through ANDROFERT (world-class micro-TESE and varicocele outcomes) and JCI-accredited hospitals with multidisciplinary reproductive care. However, substanti... Full report
    The evidence behind this score 5 cited points
    • Dr. Sandro Esteves at ANDROFERT (Campinas) ranks among world's top 3 male infertility experts with 56% micro-TESE sperm retrieval success rate and 75% varicocele microsurgery improvement rate, exceeding international benchmarks
    • JCI-accredited hospitals (Hospital Israelita Albert Einstein, Hospital Sírio-Libanês) provide internationally benchmarked surgical environments with advanced laparoscopic, robotic, and microsurgical capabilities
    • Only 20% of Brazilian gynecology/obstetrics residency programs include formal laparoscopy instruction; 50% of laparoscopy training programs concentrated in southeast, creating geographic inequality
    • ~50% of 193 ART centers are REDLARA-accredited; 85.1% of surveyed clinics treat international patients with major centers offering dedicated multilingual support and 60+ international insurance plan affiliations
    • Report explicitly states Brazil 'lacks standardized, publicly available surgical outcome data specific to fertility surgery (tubal patency rates, endometriosis recurrence rates, complication rates by center)' and that female fertility surgery is 'considerably more uneven in quality and geographic distribution' than male reproductive surgery

    Read the full Brazil report →

See the full ranking, the 1–5 rubric and the reports →