What is endometriosis and adenomyosis? This is a condition where the endometrial lining cells grow outside the endometrial cavity. If it occurs in the ovaries, it forms chocolate cysts. In the uterine wall it forms adenomyomas. Such patients often have severe pain during menses and also during intercourse. These are important causes of infertility. Treatment modalities include removal of chocolate cysts, adhesions and adenomyomas. Medical therapy includes ovarian suppression with tablets or injections. It is also important to assess ovarian reserve in such patients so that timely treatment options like Assisted reproductive techniques can be used.