Comparing the impact of dienogest with short term gonadotropin-releasing hormone (GnRH) analogue usage in endometriosis prior to laparoscopic cystectomy.

INTERVENTION: Prior to the initiation of the study, blood will be taken for series of investigations‐ for AMH, Ca 125, FSH/LH level. Transvaginal ultrasound will be performed to look for antral follicular count. Participants are allocated into one of three groups: Group 1: No pretreatment administered pre‐operatively (control group) Group 2: single dose of GnRH analogue will be given (s/c lucrin 3.75mg) 1 month prior to the surgery date Group 3: oral dienogest 2mg daily will be given to be taken for 30 days A laparoscopic cystectomy will be performed 1 month after the initiation of the above treatment. After the operation all participants are also assessed regarding overall satisfaction of the treatment that they have received. Randomisation is made by computerised block randomisation. Patient will pick 1 out of 3 sealed envelope the patient is not blinded by the treatment that they will receive, the surgeon however will not be made aware of the treatment received by their patient. CONDITION: Endometriosis ; Urological and Genital Diseases PRIMARY OUTCOME: 1. Feasibility of cyst extraction intraoperatively (rating: easy/moderate/difficult); 2. Duration of surgery (recorded in minutes); 2. Patient satisfaction with the post operative pain relief using a visual analogue score SECONDARY OUTCOME: Intraoperative blood loss in millilitres. Outcome will be retrieved from the surgical notes, anaesthetists notes on or after hospital discharge. INCLUSION CRITERIA: 1. Patients with cyst suspicious of endometrioma 2. Cyst measures > 4 cm 3. Planned for a laparoscopic cystectomy