What are ovarian chocolate cysts? ”Ovarian chocolate cysts are mostly benign cysts formed when the endometrium is ectopic to the ovary. The endometrium-like tissue bleeds into the cystic cavity during menstruation, and as the disease progresses, the blood accumulation gradually increases and becomes viscous and chocolate in color. Most patients are asymptomatic, and some patients present with acute or chronic abdominal pain. Do ovarian chocolate cysts require treatment? Even if the diagnosis is clear, the patient’s age, fertility requirements, size of the cyst, and the presence of clinical symptoms should be taken into account, rather than copying other treatments. If surgical treatment is needed, laparoscopic surgery can be considered, which is minimally invasive and has a quick recovery after surgery. Generally, postoperative medications such as GnRHa or progesterone are given as an adjunct to prevent recurrence.