Does prolonged GnRH agonist suppression improve IVF outcomes in endometriosis?

[Verified against ESHRE Endometriosis Guideline 2022] No. Extended administration of a GnRH agonist prior to ART to improve live birth rate in infertile women with endometriosis — the ultralong protocol — is NOT recommended. ESHRE grades this a strong recommendation, on the basis that the benefit is uncertain. This is an explicit change from the previous version of the guideline, where the ultralong protocol had been included. It is listed among the recommendations that were withdrawn due to unclear benefit. Practical implication: units still running ultralong downregulation for endometriosis patients before IVF are working from superseded guidance. The protocol adds months of treatment, cost, and hypo-oestrogenic side effects for a benefit ESHRE now considers unproven. Related recommendations from the same guideline worth knowing: When surgery is performed for ovarian endometrioma, cystectomy is recommended over drainage and coagulation, as cystectomy reduces recurrence. Cystectomy and CO2 laser vaporisation can both be considered, with similar recurrence rates beyond the first year; early post-surgical recurrence may be lower after cystectomy. The Endometriosis Fertility Index was added as a step to support decision-making on the most appropriate route to pregnancy after surgery. Reviewer: our corpus cites "ESHRE Endometriosis Guideline 2022" for endometriosis throughout. The guideline I have verified is 2022. Please confirm whether a 2024 version exists — if not, those citations are wrong across every endometriosis answer.