| I have a large chocolate cyst maybe 10.7cm on my left ovary. A surgeon has told me they can keep the ovary with a twenty five percent risk of recurrence or remove it and leave me with only one ovary on the right side. Is it normal or okay to remove one ovary? Does everyone need to remove one ovary for large chocolate cyst? |
When should endometriosis be re-evaluated?
I’m 33years old. I was diagnosed with stage 1 endometriosis via laparoscopy in 2021 when doing fertility treatments. My symptoms were/are infertility, pain with sex,
November 5, 2025
I am sorry you are having to deal with this. The first thing to understand is that if you have an endometrioma cyst, then that means your endometriosis is at least a Stage III, potentially a Stage IV, which is the most severe. In these situations, there is almost always significant endometriosis outside the cyst as well, often in tricky locations like near the bladder, rectum or kidney tubes. Therefore, it is important to seek out a high-volume endometriosis excision surgeon no matter which surgery you choose.
To answer your question about which surgery is preferred – the answer depends a lot on your age and your future fertility wishes.
If you are young and desire future fertility, I would strongly recommend finding a surgeon who is confident they can just remove the cyst, save your ovary, do a thorough excision of all other endometriosis, and check to see if your tubes are open. We know that high-volume surgeons do less damage to the normal ovarian tissue and have better fertility outcomes. Unfortunately, endometriomas do have a fairly high risk of recurrence, but if you go on birth control pills after the cyst is removed, then that significantly decreases the risk of recurrence. (Although obviously, you can’t be on birth control pills while you are actively trying to get pregnant.)If you don’t desire future fertility, then a hysterectomy with removal of affected ovaries (those with endometrioma cysts or ovaries that are involved in significant adhesions) and a thorough excision of all other endometriosis is the surgery most likely to give the best and longest lasting pain relief, and the least risk of recurrence.