What is the optimal interval between surgery and IVF in endometriosis?

[Partially verified against ESHRE Guideline: Endometriosis 2022] The premise deserves examination before the interval question. ESHRE strongly recommends against routine surgery prior to ART to improve live birth rate, and specifically against routine endometrioma surgery for that purpose. So for many patients the correct interval is not the question — the surgery itself was not indicated for fertility purposes. Where surgery has been performed for a legitimate indication (pain, follicle accessibility, or as an individualised decision in deep disease), ESHRE 2022 does not specify an optimal interval before proceeding to ART. I could not locate a recommendation on timing in the guideline, and that absence should be stated rather than filled in. Practical considerations that do bear on timing: Post-operative recovery and resolution of inflammation. Ovarian reserve reassessment after endometrioma cystectomy, since AMH commonly falls following the procedure and the post-operative value is what should inform stimulation planning. Age and reserve — delay costs more in older women with diminished reserve, and this often outweighs any theoretical benefit of waiting. The Endometriosis Fertility Index, added in this guideline version, is designed to support exactly this decision — whether to attempt natural conception after surgery or proceed to ART, and how long to allow. Reviewer: please confirm whether any society specifies an interval. If none does, this answer should say so plainly rather than implying a standard exists.