Do endometriomas affect fertility or ovarian reserve?

Yes—endometriomas can affect fertility and may be associated with a lower ovarian reserve in some patients. They can drive inflammation in and around the ovary, interfere with normal ovulation mechanics, and sometimes reduce how the ovary responds to fertility medications or how straightforward egg retrieval is.

Ovarian reserve can be impacted by the endometrioma itself, and it can also be affected by surgery—especially repeat cyst surgery—because healthy ovarian tissue can be inadvertently removed or the blood supply altered. When we help patients plan next steps, we weigh symptoms and cyst characteristics alongside age, AMH and antral follicle count, prior surgeries, and your timeline for pregnancy. Depending on your goals, options may include monitoring, medical suppression, fertility treatment first, or thoughtfully planned surgery designed to treat disease while prioritizing ovarian function; our team can help you map out the safest path forward.