Ovarian endometriosis is extremely complex to operate on, for the simple reason that there is no cleavage plane between the endometriotic cyst to be removed and the ovarian cortex, seat of the antral follicles (ovarian reserve)(14). It is essential to preserve this ovarian reserve, as it does not renew itself over time. Great care must therefore be taken with this capital, and the right surgical decision taken according to the desire for pregnancy, possible infertility or the desire to maintain ovarian function(9).
There are 2 ways of treating endometriotic ovarian cysts: cystectomy or laser ablation. Sclerotherapy and alcoholization techniques will not be mentioned here, as they are in the process of being validated and have not yet found their exact place in management.
Before any surgical intervention for ovarian endometriosis, it is essential to have an idea of the ovarian reserve, so that you can compare it postoperatively and have an idea of how it will be maintained. This is an integral part of management.
