I have a cyst that was 4cm a year and a half ago. it grew to 10cm and then shrunk to 8.4 in 2 months. ob gyn gave two choices. watch and wait or laparoscopic cystectomy. what should i do? cyst is complex hypoechoic (possible endometrioma)

Won't go away on own: Only you can make the decision; however, something to think about is this: If it has persisted for 1.5 years, its unlikely to go away on its own. The difference in size in 2 months from 10cm to 8.4cm may just be the way the ultrasound measurements were taken. It may not be shrinking. I would recommend removing an 8+ cm cyst that is persistent after observation. Best wishes!

Laparoscopy: It is good to watch complex hypoechoic cysts which cause pain as most of these cysts are physiological instead of pathological, and will go away in two months. While waiting you can get blood tests to help determine the nature of the ovarian cyst such as a CA-125, Ova-1, or ROMA. Ultrasound with Doppler helps rule out twisted ovarian cyst. After 2 months consider laparoscopic cystectomy.

Laparoscopy: Cysts that are complex on ultrasound usually do not resolve on their own. More often than not they need to be drained surgically. An endometrioma often contains old blood (thus the term chocolate cyst) that cannot resorb spontaneously. Surgical drainage and treatment of any other endometriosis lesions can be done laparoscopically.