IVF is commonly applied to all indications for infertility, but increasingly unexplained causes predominate (www.sart.org). Specifically, endometriosis is listed as the primary diagnosis in less than 4% of cases in the United States, primarily because laparoscopy is not performed for the basic infertility workup, as it once was (1). Unexplained cases of infertility show a high prevalence of endometriosis (2, 3). Visible endometriosis such as endometriomas present a special challenge, especially since ovarian reserve may be compromised when ovarian surgery is performed.