Laparoscopic cystectomy for endometriomas is preferable to coagulation or laser vaporization with regard to recurrence of cysts and symptoms and subsequent spontaneous pregnancy in women who were previously subfertile . If an endometrioma >4 cm in diameter is present before IVF, cystectomy is specifically recommended to confirm the diagnosis histologically; reduce the risk of infection following egg retrieval; improve access to follicles and possibly improve the ovarian response to gonadotrophins . When the endometrioma is large, the remaining ovarian capsule is so thin that excision and coagulation will almost invariably remove or destroy a large part of the normal ovarian tissue. Therefore, a two-step procedure (marsupialization and rinsing followed by 3 months GnRH agonist therapy and then repeat surgery) should be considered if fertility is to be conserved; otherwise an oophorectomy should be considered as it is technically easier. Fertility patients should be counselled about the risks of reduced ovarian function after endometrioma excision and the loss of an ovary.
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A Beginner's Guide to Healthy Pregnancy. If you suspect, or know, that you are pregnant, we ho pe you have already visited your doctor. Presuming that you have confirmed your suspicions and that this is your first child, or that you wish to take better care of yourself d uring pregnancy than you did during your other pregnancies; you have come to the right place.