In vitro fertilization (IVF) for poor responders—patients with diminished ovarian reserve and limited response to ovarian stimulation—presents unique challenges to achieving pregnancy. A potential intervention to improve reproductive outcomes in this group is the removal of interstitial myomas, benign tumors within the uterine muscle layer. These fibroids can impair fertility by distorting the uterine cavity, affecting blood flow, and creating an inflammatory environment. Surgical dissection may enhance uterine receptivity, yet its effectiveness for poor responders specifically remains under-explored. This review examines current evidence and highlights the need for targeted studies.