New Here - To Lap or not to Lap (4cm endo... - Endometriosis UK

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New Here - To Lap or not to Lap (4cm endometrial cyst)?


Hello everyone,

New to this site and forums in general but hoping you can help me understand things and decide.

We've been ttc for over two years now, and the doctor has found nothing wrong except for a 4cm endometrial cyst in my ovary. She said that it's not small enough to ignore but not big enough to get concerned about, and as I have no other symptoms aside from painful periods, it's up to me whether to go for a laparoscopy to get it removed or not.

Have read mixed things online - some say it's too small and not worth the risks of surgery, some say that chances of conception increase after a laparoscopy so it's worth trying. I've never had any kind of surgery before so a bit scared by the whole thing, but I don't want to miss a chance to increase fertility.

We have also submitted an application for IVF... Will the laparoscopy help or complicate the IVF procedure?

What do you think? What should I do?



5 Replies


When you say it's an endometrial cyst I assume you've been told it is an endometrioma? If so, it would be unusual not to have endometriosis elsewhere.

We were in a similar position and it's a difficult decision to make. I had endometriomas in both ovaries and decided to proceed with IVF. They were also about 4cm so borderline for surgery.

I had to have a general anaesthetic for egg collection as they were concerned that the pressure used would be too painful. However, they had to put the needle through one endometrioma to be able to retrieve the eggs which was extremely painful for ages afterwards!!!

I have since had surgery to remove the endometriosis which was widespread and another unsuccessful round of IVF. Unfortunately one of the endometriomas grew back within 3 months.

Have you spoken to an IVF consultant yet? It may be helpful to speak to someone for their advice to help you make the decision. As with any surgery there will be risks - damage to the ovary and formation of scar tissue.

I'm not sure if any of this really helps as only you can make the decision but let me know if you have any questions xx

I've also been doing research into this. Larposcopy will help determine the extent of endo , as pain is not an indicator to how sever the stage of endo is.

Also the removal of endo will helps increase the success rate of natural conception or through ivf.

I've read Usually by the time chocolate cyst are forming its stage 3-4. Also excising rather than abalation of endo is the best way to successfully and permanently cure the condition. Good luck xx

Hi , I do have chocolate cyst do u have any info on how to naturally maybe help to get rid of it

Sorry not much help on the natural route, although the cyst could eventually disappear itself. Although if you google endometriosis it need to be treated sooner rather than later. The longer you leave the endo the more likely it will grow & compromise ur fertility. To slow or stop the endo from getting worse you must take medication, but all of the medications stop you getting pregnant. Remember if you have an endo cyst it will more than likely be growing else where, it is very small and does not show on ultra sounds or MRI until it's very sever. Lap is the only true way to diagnose the extent of the disease and excising the disease. It's scary but if you want to have the best chance of successful ivf have the surgery then @ least 60 days of prostap/GnRHa to reduce the inflammation that endo causes x

Thank u so much , My oB gyn said that I have chocolate cyst and very few adhesions, I'm so scared to have a surgery but I would like to conceive soon.

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