Dear Sir, My wife 26 years old suffers from endometriosis , completed marriage one year from Feb-10 to Feb-11. She had a lap surgery last July-10 , & following are reports: Before surgery Ultrasound report: Endometrium thin ecogenic. Both ovaries are enlarged cystic measures 6.5 x 5cm & 5 x 5cm with internal echoes s/o endometrioma placed very close to each other behind uterus. After lap surgery: Operative finding: 1) Uterus mid-position , normal size. 2)Both adnexa & recto sigmoid forming densely adherent mass completely obliterating the POD & uterine fundus. 3)Old blood straining entire peritoneal cavity , pelvis , lower & upper cavity & omentum.20-30 cc old blood in pelvis indicating ruptured endometrioma. Operative procedure: 1)Attempt was made to dissect right tubo ovarian mass from posterior surface of uterus & gut. Could not be done due to dense adhesions. 2)Right endometrioma opened , had become heterogeneous inflammatory mass , partially resected. 3) Hemostasis & peritoneal toileting done. Plan: Luprodite given for 3 months till oct-10 to check mensus period. During menstruation period , pain checked . After 3 months ultrasound done on Mar-11: Report: Right ovary is hypertrophied ( 56mm x 43mm) it shows a cystic structure , which measures 46mm x 37mm in approximate dimension. Fluid shows floating echogenic particles( chocolate cyst). Left ovary is hypertrophied ( 56mmx42mm) . It shows few echogenic structures out of which the biggest one measures 23mm x 15 mm.All these echogenic areas are suggestive of endometriosis. Nearer to the left ovary there is a tubular cystic structure containing echogenic fluid ( Endometriosis of Left Fallopian tube.) Impression: 1)     Bilateral ovarian endometriosis with chocolate cyst in right Ovary & Endometriosis of Left fallopian tube. Please suggest the treatment , as doctors unable to recommend further.