A common clinical dilemma in specialized practice For women with ovarian endometrioma who wish to become pregnant, choosing a surgical strategy remains a complex decision. Clinicians must balance disease control, preservation of ovarian reserve, and optimization of pregnancy chances, in a context where high-level comparative data remain limited. Ovarian endometriomas are a specific form of endometriosis, affecting 17 to 44% of patients with the disease¹. Defined as endometrio