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Abstract SUMMARY Endometrioma is the formation of a cyst within the ovary with ectopic endometrium tissue lining and is found to be in 17%–44% of patients with endometriosis. It is hypothesized that endometriomas arise as a consequence of coelomic metaplasia of the ovarian epithelium or the invagination of the inverted ovarian cortex after implantation of the endometriotic foci on the ovarian surface. In either case the cyst has a pseudocapsule adjacent to the normal ovarian tissue. Although the most effective treatment modality of endometrioma is controversial, laparoscopic excision by the stripping technique is accepted to be the gold standard surgical approach but in comparison to drainage and ablative surgery, excision of endometriomas are better in terms of reduced pain, , and decreased recurrence and reoperation rates, but one of the major concerns about excision of endometriomas is their negative effect on ovarian reserve. The aim of this study is to determine whether laparoscopic surgical excision or ablation is the optimum surgical management of ovarian endometriomas with respect to pain, recurrence, ovarian reserve and fertility outcomes. The study included forty women attended the gynecological and infertility clinic of Tanta University hospital presented by ovarian endometrioma measuring three centimeters or more unilateral or bilateral. Their ages ranged between 18 – 40 years and AMH above 2.0ng /ml. The forty women randomly allocated using computer program into two groups according to subsequent management. group I: Twenty one cases subjected to laparoscopic ovarian cystectomy (stripping) of endometrioma. |