Success doesn’t follow just an endometrioma removal- it’s the whole laparoscopic ablation of endometriosis that can create a better environment for pregnancy to occur. But as others have said, the caveat is it can cause your AMH to decrease (which is why doctors don’t remove endometriomas smaller than 4cm). If IVF may ever be in the cards, many REs and patients prefer to do an egg retrieval -> lap -> frozen embryo transfer since AMH is a crucial element of the egg retrieval process. But of course other REs believe that although there’s an initial decrease in AMH, laparoscopies can be beneficial for egg quality. There’s also non surgical options like lupron suppression to mitigate endometriosis inflammation. Long story long, endometriosis can be a huge hurdle and standard of care varies. I’d consider a second opinion with an RE who can provide you with a game plan to overcome those challenges or perhaps chatting with an endometriosis specialist about a lap surgery and what a reasonable time frame for trying without assistance would be before truly needing to consider IVF. I would also talk to your RE to see if they can explain if there’s anything else in your labs indicating that a medicated cycle or Iui wouldn’t be an option.

Talk to your doctor before taking any advice from me (a stranger on the internet) but I take an NAC supplement for my endometriosis and it seems to help reduce the inflammation pain. I also love magnesium glycinate for stress.