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However, cystectomy for large endometriomas may reduce ovarian reserve, as indicated by decreased anti\u2010M\u00fcllerian hormone (AMH) levels. This case report presents a triple\u2010step approach to managing a 20\u2010year\u2010old woman with bilateral endometriomas and infertility, focusing on preserving ovarian function. The patient, with primary infertility for 2 years and large bilateral endometriomas (10\u2009cm on the right ovary and 5\u2009cm on the left), underwent a staged treatment. Step 1 involved laparoscopic drainage of the cysts, followed by 3 months of GnRH agonist therapy to shrink the cysts and suppress endometriosis. Step 2 was a laparoscopic cystectomy performed carefully to minimize ovarian tissue loss. Step 3 included 3 more months of postoperative GnRH agonist therapy to suppress residual disease and aid ovarian recovery. Predrainage AMH was 3.27\u2009ng\/mL, decreased slightly to 3.17\u2009ng\/mL at 6 months after surgery, and was 2.54\u2009ng\/mL at 12 months of follow\u2010up, indicating minimal ovarian reserve depletion. The patient resumed regular menstrual cycles 3 months postoperatively and conceived within 1 year, with no evidence of endometrioma recurrence observed. This case highlights the effectiveness of the triple\u2010step approach in managing giant endometriomas while preserving fertility. Combining medical and surgical methods reduced AMH depletion and improved reproductive outcomes. This strategy may be a valuable option for young women with endometriomas, though further research is needed to confirm its long\u2010term benefits.<\/jats:p>","DOI":"10.1155\/crog\/9079350","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T08:19:50Z","timestamp":1777364390000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preserving Fertility in Young Women: Triple\u2010Step Strategy for Managing Giant Endometriomas With Minimal AMH Decline\u2014A Case Report"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8049-1520","authenticated-orcid":false,"given":"Arry","family":"Soryadharma","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3352-8664","authenticated-orcid":false,"given":"Hanom 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