Received June 16, 2024
Accepted December 24, 2024

Endometriosis is a chronic disease that affects approximately 10% of reproductive-aged women worldwide and is a common cause of infertility. One of its manifestations is ovarian endometriomas, which are present in 17-44% of endometriosis patients. Endometriomas can impair fertility by mechanical stretching and local inflammation, promoting oxidative stress in the surrounding ovarian cortex that could lead to the apoptosis and necrosis of early follicles. The removal of endometriomas may improve spontaneous pregnancy rates, as already demonstrated by some studies. To reduce endometrioma recurrence, cystectomy followed by hormonal suppression is advised. However, this approach is unfeasible for patients who desire to become pregnant. At the same time, cystectomy can negatively impact the ovarian reserve and, therefore, controlled ovarian stimulation. Women who undergo surgical removal of endometriomas are at risk of having a diminished response to ovarian stimulation if in vitro fertilization is needed in the future.