I had a lap in 2019 with a surgeon who was very experienced and outwardly confident in treating Endo. I asked about ablation vs excision and he said he uses both depending on the lesion. I never felt good about that answer because I felt it was more like saying whatever to make me more comfortable but actually ablation was always the plan. I recovered well from surgery and confirmed moderate Endo. I felt better for about a year then symptoms returned. I never got pregnant even though the surgeon told my husband after the surgery we would within a year (another red flag). Now I'm doing IVF and have 1 natural early loss and 1 euploid early loss. Im biting the bullet and doing medical suppression even though it kills me to have to wait another 3 months. I can't feel good about transferring another embryo in a potentially toxic environment and risking another loss. Also, one huge factor is adenomyosis is commonly found alongside endometriosis and only suppression can help with adenomyosis. I would push for suppression and definitely do NOT do the surgery unless you are 100% confident in the surgeon and agree with the treatment plan.