Hi, I m a 41 yo female. Previous hx of Stage 4 endometriosis, and clear cell carcinoma of the cervix (15 years ago) Last surgery for endometriosis 1 year ago. I had 2/52 ago I had pelvic u/s which confirmed 2 cysts on left ovary. One is an endometrinoma 6cmx4cmx3.5cm, one is a plain benign cyst 2cmx1.5x1cm. U/s also confirmed adenomyosis, and endometriosis in pelvic region. Right ovary is diminished in size and only contains 2-3 small follicles (I had an ovarian cyst on it 17 years ago which burst). We have a 2.5 yo daughter and am keen to start IVF very soon. I have been unable to conceive spontaneously past 2 years due to endometriosis and Hashimoto s Disease. Q1) Do I have surgery, knowing I risk losing the left ovary completely? Q2) If I forgo the surgery, will egg retrieval for IVF be possible despite the endometrinoma? Q3) If I forgo surgery, and am able to proceed to IVF, will I be able to take strong analgesia for endometriosis pain during the cycle? Thank you in advance :)