The aim of this study is to evaluate the impact of laparoscopic ovarian cystectomy versus aspiration and coagulation on ovarian reserve and pelvic pain in cases of ovarian endometrioma.

All patients are presenting with ovarian endometrioma. They are all subjected to informed written consent, full history, general examination, local examination and transvaginal ultrasound. Follicular stimulating hormone (FSH), Lutenizing hormone (LH), Anti Mullerian hormone (AMH), Antral follicular count (AFC) and chronic pelvic pain which is assessed by Visual Analogue Scale (VAS) of pain scoring system ,all are to be determined before and after laparoscopic surgery (postoperative three months); for two groups (Group A) cystectomy and (Group B) aspiration and coagulation. Histopathological examination was done to the cystectomy group to confirm endometriosis and detect the presence of healthy ovarian tissue in the excised cyst wall.

Inclusion Criteria:

• Female with age group 20-40 years.
• Female diagnosed by ultrasound with unilateral ovarian endometrioma ≥3cm.

Exclusion Criteria:

• Previous ovarian surgery.
• Endocrinological diseases affecting ovarian reserve e.g. Diabetes mellitus, hypothyroidism.
• Polycystic ovary syndrome (PCO).
• Suspicion of ovarian malignancy by ultrasound.
• Other pelvic pathology e.g. uterine fibroid, pelvic inflammatory disease (PID).
• High basal FSH >10mIU/mL (milli-international unit per milliliter).