The short explanation
An endometrioma, often called a chocolate cyst because of the old dark blood inside, is a cyst on the ovary caused by endometriosis. Endometriosis can make getting pregnant harder for some women, but many women with endometriomas do conceive, either naturally or with help. Whether it affects your chances depends on the size of the cyst, how much endometriosis there is elsewhere, your age, your egg reserve, your partner's semen test and whether your tubes are open. After a year of trying, a fertility assessment for both of you is a reasonable next step. Surgery to remove the cyst is not always the first choice, because it can reduce the number of eggs in that ovary, so the decision is made carefully.
What depends on your situation
The parts of this that change from woman to woman. Uncertainty is stated, not hidden.
- Common tests include a blood test for egg reserve, a check that the tubes are open, and a semen analysis for your partner.
- Options can include trying naturally for a while longer, fertility treatment, or surgery for some women with large cysts or severe pain.
- If possible, seeing a gynaecologist with experience in endometriosis and fertility helps.
What this answer cannot determine
The boundary of online education. These need a clinician who can see you.
- This answer cannot tell how the cyst affects your fertility. That depends on tests for both partners and a specialist's assessment.
Questions for your clinician
Take these with you. You can add any of them to an appointment card.
- How large is the cyst, and does it need treatment?
- Should we do fertility tests for both of us now?
- Would surgery help or harm my egg reserve?
- What are our options if we do not conceive naturally?
When to seek help
Clinician-approved guidance for this topic. When in doubt, being seen is never the wrong choice.
Emergency — call 112 now
- Call 112 or go to the nearest emergency department if you have sudden severe pelvic pain with vomiting or fainting, which can happen if a cyst bursts or twists.
Get help the same day
- Get care the same day if you have pelvic pain with fever.
Raise it at a routine appointment
- Book a fertility review with a gynaecologist since you have been trying for a year.
Sources
The evidence this explanation is built on.
- Endometriosis NHS
- Endometriosis Cleveland Clinic
- Endometriosis World Health Organization
Who wrote and reviewed this
Every AskHer answer names its author. A clinically reviewed answer also names the clinician who signed it off — if no clinician is named below, it has not been clinically reviewed.
- Author
- AskHer Editorial (AI-assisted draft) AskHer's editorial team — not an individual clinician Works in English, தமிழ், हिन्दी
- Clinical reviewer
- Nobody yet No clinician has signed this answer off, and no person on the editorial team has read it yet. That is what the “Written with AI assistance” label means. It is queued for an editor to read, and then for a clinician who works in this area. The sources it was drafted against are listed above.
- Review status
- Written with AI assistance — not yet reviewed by a person
- Last reviewed
- Not yet reviewed by a person
- Version
- 1
Correction history
Substantive changes are listed, not quietly edited away.
No corrections have been made since this answer was first published.
Did this answer your question?
Whatever you choose is filed against this version of the answer, never against you, and it is never shown as a count.
“Explain more simply” asks you which part was hard to follow, so the author knows what to rewrite. “My question is different” opens a private follow-up with this answer attached.
Saving, following up and reporting are all private. Nothing you do on this page is visible to other readers or to the doctor who wrote it, unless you ask a question.