Dr. Antonio Gargiulo

Patient Feedback

Patterns Across Patient Feedback

Endometriosis Focus

Endometriosis Excision Within a Fertility and Reproductive Surgery Practice

Dr. Gargiulo is Medical Director of Advanced Reproductive Surgery at Fertility Centers of New England, seeing patients in Boston and Reading in Massachusetts and in Stratham, New Hampshire. He operates at hospitals across the region, and patient accounts place surgeries at Exeter Hospital in New Hampshire, Lahey Hospital and Medical Center, Winchester Hospital, and previously at Brigham and Women's Hospital, where he practiced for about thirty years before moving to his current practice. He does not practice obstetrics. His practice is entirely reproductive endocrinology and reproductive surgery, and by his own account it shifted mostly to surgery beginning around 2006.

His training is worth understanding precisely, because his bios lead with Harvard. His fellowship was in reproductive endocrinology and infertility at Brigham and Women's Hospital, completed in 1998. That is a fertility fellowship, not an endometriosis fellowship or a fellowship in minimally invasive gynecologic surgery. His residency in obstetrics and gynecology was at the University of Texas in Houston, and he graduated from medical school at the University of Naples in Italy. He is board certified by ABOG in obstetrics and gynecology and in reproductive endocrinology and infertility, and he additionally holds an ABOG Focused Practice Designation in minimally invasive gynecologic surgery, which is a separate credential from board certification. His endometriosis surgical skill appears to have been built after fellowship rather than during it.

Endometriosis excision is named as a specific focus of his practice on his own materials, alongside fibroids, adenomyosis, and complex uterine anomalies. He is listed on iCareBetter with a video-vetted excision tag, and his listed areas of endometriosis expertise there include pelvic, ovarian, bowel, and bladder and urinary disease. He accepts most insurance and is accepting new patients, with a stated six to twelve month wait for new surgical patients.

Multidisciplinary Approach

Specialist Teams Built Around the Case

Building a surgical team around the individual patient is something he talks about publicly and something patients describe happening. His stated position is that endometriosis can involve bladder, ureters, bowel, and nerves, that no single surgeon can be expert in all of it, and that patients should ask in advance which other surgeons will be present if disease extends beyond the reproductive organs.

Accounts bear this out across several hospitals. One patient describes a colorectal surgeon joining partway through her operation to remove disease from the colon. Another describes a combined pelvic and chest operation performed on the same day with a thoracic surgeon, for disease affecting the diaphragm that had been causing shoulder pain, breathlessness, and collapsed lung episodes. Another describes a urologist involved in an operation that required removing a diseased section of ureter and reattaching it to the bladder. Another describes a general surgeon removing an inflamed appendix during the same procedure. Lahey Hospital, where he operates, runs its own endometriosis program with colorectal, thoracic, plastic surgery, and pelvic floor physical therapy on the team.

Beyond the operating room, pelvic floor physical therapy is described in his public writing as an essential part of modern endometriosis care and as an essential complement to surgery, and patients describe being sent for it afterward. He has said that patients whose pain persists despite surgery, medication, and pelvic floor work are referred on to specialized pain management, and that he works with anesthesiology and neurology colleagues on those cases. His listed approach to persistent pain also includes bringing in urology, gastroenterology, neurology and orthopedics, rheumatology, and mental health assessment, and re-examining for missed disease, hernia, or adhesions. One patient describes being referred to an outside specialist for immune-related recurrent pregnancy loss and to interventional radiology for hip and sciatic pain.

Diagnosis Methods

Imaging First, But Only Imaging Done and Read the Right Way

His diagnostic position is that imaging before surgery is now the right first step, and that the quality of that imaging is what determines whether it means anything. He has been public about generic pelvic MRI being close to useless for endometriosis, and has said scans must be done on a specific endometriosis protocol and read by a radiologist trained to look for the disease. He has also said that a patient who arrives having already had imaging done at a non-specialized center will most likely be asked to repeat it.

Patient accounts describe that in practice. Several report being sent for pelvic and abdominal MRI on a particular protocol at a facility chosen because its radiologists read for endometriosis, with bowel preparation and a liquid diet beforehand. Others describe three-dimensional ultrasound, hysteroscopy, and blood tests including tumour markers before operating on a large ovarian cyst, which one patient was told was to establish whether the cyst could be safely handled.

On the broader question of being believed, his stated view is that severe cyclical pelvic pain is basically never in a patient's head, that endometriosis is probably more common than period pain without a known cause, and that pain cannot be measured with an instrument so a doctor has to be willing to listen. He has said that around eighty five percent of his endometriosis patients arrive without a referral from another doctor.

Educational Presence

A Large and Active Public Voice, Concentrated on Instagram

His own educational output is substantial and he runs it himself. His Instagram account is the centre of it, and it is where his endometriosis teaching actually lives. A 2026 series called "What I Wish Every Patient Knew Before Endometriosis Surgery" walks through what patients should ask a prospective surgeon, including what the surgical plan is and which other specialists will be in the room.

He has posted on why a generic pelvic MRI is not adequate, and on robotic technique. In one 2026 video he argues that the single billing code covering all endometriosis surgery pays the same for a five minute surface treatment as for a five hour full excision, and that this is a central reason so few surgeons train for the harder work. In another he says he will not make videos of patients praising him, that patients are not his marketing department, and that the imbalance of authority between doctor and patient makes that kind of content inappropriate, and that he would rather earn trust through education.

He is publicly critical of professional bodies in his field. On LinkedIn in 2025 he commented on an American College of Obstetricians and Gynecologists issue brief on restorative reproductive medicine, arguing it effectively tells doctors not to spend time looking for or treating endometriosis in fertility care and to proceed to IVF instead, calling that unsupported by evidence and a step backwards. He wrote that the organization has long been indifferent to what women with endometriosis actually live through, and said he left it about ten years ago.

He has also curated a set of videos on Roon covering his philosophy of care and common patient questions, runs an educational website at newenglandendometriosis.com carrying articles on endometriosis surgery, on endometriosis and autoimmunity, and on non-surgical diagnostic tests, and he medically reviewed a widely read consumer article on endometriosis for Ro. He wrote a guest post on adenomyosis for AllPaths Family Building setting out ten things a fertility patient with that diagnosis should understand.

On the conference and society side, he appeared at The Endometriosis Summit in 2021 in a session on adenomyosis with Dr. Andrea Vidali, features in the Society of Endometriosis and Uterine Disorders interview series, and joined a 2026 SEUD panel on the future of endometriosis care. He attended AAGL in 2023 and posted publicly in praise of its first endometriosis patient advocacy panel, while criticizing his own profession for not listening enough. He is a member of ACOG, ASRM, ESHRE, AAGL, the Society of Reproductive Surgeons, and the Society of Robotic Surgery, and has been Harvard Medical School faculty for close to three decades.

His peer-reviewed publication record is worth describing accurately. It is large, and it is mostly about robotic surgery and fibroid surgery rather than endometriosis. The endometriosis-specific work includes a paper on single-incision robotic removal of ovarian endometriomas, a paper on surgical technique for adenomyosis, an early paper on hormonal management of endometriosis, a commentary endorsing the 2021 AAGL system for classifying endometriosis by surgical complexity rather than by effect on fertility, and a 2026 joint opinion paper on endometriosis management published on behalf of the Society of Endometriosis and Uterine Disorders and the American Institute for Minimally Invasive Surgery, on which he is one of nine authors. When Brigham and Women's created two specialized centers in 2021, he co-led the fibroid and uterine anomalies center, and the endometriosis center was led by other physicians, though he was a listed member of it.

Post-Surgical Care

Personally Involved in Recovery, With Limited Public Detail on Structure

Patient accounts describe him as personally present after surgery. Several report him calling to check in himself, including at night and after a patient had moved out of state, and updating family members directly after an operation. Post-operative appointments in person are mentioned, and several patients say they were walked through exactly what was found and what was done, with one saying the operative notes matched what she had been told to expect from her MRI.

Patients from out of state describe being able to do much of the surrounding care remotely.

Pelvic floor physical therapy after surgery is a recurring element, and one patient describes still using exercises learned in post-operative physical therapy a year later when symptoms flare. Recovery experiences vary widely in the accounts. Several patients report going home the same day with minimal pain, and one describes needing only over the counter medication after a hysterectomy and excision. Another was frustrated that her pain took a full four months to lift, and shared her account specifically so that other patients would not assume something had gone wrong if relief was not immediate.

On medication after surgery, his stated approach is that first line treatment is progestins and non-steroidal anti-inflammatory drugs, and that he uses stronger hormone-suppressing drugs only for adenomyosis patients in the context of IVF. One patient with adenomyosis describes exactly that sequence before an embryo transfer. Another patient, treated for pain rather than fertility, says he did not push birth control on her afterward. No public information was found on standard follow-up timing or how long patients continue to be seen after surgery.

Philosophy and Fit

Complete Removal, Fertility Preservation, and a Fertility-Centered Frame

The clearest and most consistent thread in his public statements is that endometriosis has to come out completely. He has said there is only one correct way to treat it, which is to excise it, that none should be left in place, and that disease will persist or return if it is not fully removed, while acknowledging that even complete excision does not guarantee it never comes back. He has been openly critical of the incentives in American medicine that in his view reward managing endometriosis over developing the surgical skill to remove it.

The second thread is fertility preservation, and it runs through everything. He describes endometriosis affecting the ovaries as a fertility preservation emergency, and has said that some ovarian tissue is lost every time a surgeon operates on an ovarian endometrioma even in the best hands, which is why the choice of surgeon matters so much. Patients repeatedly describe organs being saved that they had been told elsewhere would have to go. He is cautious about hysterectomy for endometriosis and has written that it is rarely indicated for endo itself, though it is sometimes necessary for severe adenomyosis.

He is also cautious about how quickly to operate. Accounts describe him weighing risks and benefits carefully, and in at least one case declining to push a patient toward surgery while making clear it was available if symptoms warranted it. Another patient says she had to advocate for surgery and appreciated his caution even so. He describes his own approach to persistent pain as expanding the search rather than assuming the surgery failed.

On fit, the honest framing is this. His practice is a fertility clinic, he is a fertility specialist by training, and his public language consistently centers pregnancy, IVF outcomes, and preserving the ability to conceive. Many patients in the accounts came to him purely for pain and describe excellent care, so this is not a matter of who he will treat. But a patient whose goal is pain relief and who has no interest in pregnancy should expect fertility to be part of the conversation, and should say clearly what she wants from surgery.