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On the journey to conception, many women face challenges such as endometriosis (commonly known as “chocolate cysts”) and adenomyosis. When told that these issues may affect fertility, some may rush to seek surgical treatment. However, especially for younger women, undergoing surgery blindly may do more harm than good. The correct strategy should be to evaluate fertility first, then consider treatment options.
Chocolate cysts: Surgery is not the first choice
Chocolate cysts are a common manifestation of endometriosis, which can affect ovarian function. Many doctors suggest removing chocolate cysts before IVF, but for younger women, this should be considered with caution.
Risks of surgery: We have seen many cases where women, after surgery for chocolate cysts, had directly impaired ovarian function, making them unresponsive to medication and unable to produce eggs. This makes subsequent IVF treatments much more difficult. Therefore, the basic principle is “if you can avoid surgery, don’t do it.”
Correct strategy for younger women: If you are younger and your ovarian function is still acceptable, the priority should be to freeze eggs as soon as possible. To ensure future live birth chances, it is recommended to freeze at least 20 eggs across 3 to 5 cycles. Freezing only 5 to 8 eggs has little significance, as a certain quantity is necessary to secure a reasonable chance of success in the future.
Plan for older women: If you are older and your ovarian function has already been affected, egg freezing may no longer be the best choice. In this situation, a better strategy is to find sperm from a sperm bank, fertilize fresh eggs to create embryos, and freeze the embryos. Because ovarian function is already declining, further delays may result in no healthy embryos being produced for IVF at all.
Adenomyosis and fertility: In most cases, no need for early intervention
Similar to chocolate cysts, adenomyosis usually does not directly prevent fertility. In most cases, it does not require surgical intervention before conception or IVF.
Step-by-step fertility strategy: The current IVF process can be divided into three main steps: first, egg freezing; second, embryo creation; third, embryo transfer. The uterus is not required for the first two steps—only for embryo transfer. Therefore, if your issue is adenomyosis alone, there is generally no need for early intervention before you are ready to get pregnant.
Fertility is a complex and highly personalized journey that requires decisions based on professional medical knowledge and individual circumstances. IVF USA understands your concerns and challenges. We are committed to providing comprehensive consultation and guidance with professionalism and sincerity, helping you make responsible choices for your future in egg freezing and IVF.
Dr. Nathan Zhang founded IVF USA more than ten years ago, offering overseas assisted reproductive consultation services such as egg freezing in the United States, IVF, and third-party reproductive assistance. With nearly 20 years of experience in the field of overseas assisted reproduction, IVF USA has recognized the diversity and personalization of fertility needs and entered the Mexico market early, becoming the official Chinese partner of Power Fertility Center Mexico POWER IVF. Today, Dr. Nathan Zhang’s services extend beyond the United States to Mexico IVF and egg freezing, as well as IVF and egg freezing in Japan, Thailand, and regions such as Taiwan and Hong Kong.