An endometrioma is an ovarian cyst associated with endometriosis. Often called a “chocolate cyst,” it contains old blood and differs from the functional cysts that develop during a menstrual cycle.

Can it affect fertility?
Endometriomas may be associated with reduced ovarian reserve. However, having one does not mean pregnancy is impossible or that surgery is always necessary.

Should it be removed before IVF?
Not routinely. Current evidence does not show that removing an endometrioma solely to improve IVF outcomes increases live-birth rates. Surgery can also remove or damage healthy ovarian tissue, potentially reducing ovarian reserve.

When might surgery be considered?
Your specialist may consider surgery for significant pain, concerning imaging findings, or difficulty accessing follicles during egg retrieval.

What should guide the decision?
Your age, symptoms, cyst appearance, AMH, antral follicle count, previous ovarian surgery and fertility plans all matter. Cyst size alone should not determine treatment.

Discuss monitoring, surgery or proceeding with IVF with your fertility specialist. The aim is to address symptoms and safety while protecting ovarian function.

Longevity Fertility Centre | Calgary & Edmonton