Endometrioma Surgery That Keeps Your Ovary in St. Louis
Removing the cyst while protecting the ovary and your egg supply
One of the few surgeons in St. Louis focused on removing the cyst while preserving the ovary.
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Laura Obermoeller
1/21/2026
I started my journey a little over four years ago at The Center for Reproductive Medicine and Robotic Surgery (CRMRS) with Dr. Jacobs, and I truly can’t say enough good things about my experience. From the very first appointment, you could tell that Dr. Jacobs is a doctor who genuinely cares about his patients. He always put my health and what was best for me first, never rushed appointments, and took the time to answer every single question. I felt supported, informed, and cared for throughout the entire journey. I was fortunate enough to get pregnant on the first round of IVF, and I am beyond grateful every single day for my little girl. I truly credit Dr. Jacobs and his team for making that possible. The entire staff was incredibly kind, but Ashley, his receptionist, deserves special recognition. She was absolutely amazing — always available to answer questions, help with medications, and guide us through the financial side of things in the most cost-efficient way possible. She went above and beyond to make a very overwhelming process feel manageable. The whole process from the beginning is an emotional and stressful journey, but the compassion, support, and dedication from Dr. Jacobs and his team made all the difference. I will always be grateful for the care I received and highly recommend CRMRS to anyone considering fertility treatment.
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Brittany Corn
4/26/2025
He’s been a wonderful experience with him so far We couldn’t ask for a better doctor. We started with a different clinic, but we couldn’t ask for a better doctor with Dr. Jacobs . He’s the best and the business. I definitely recommend if you’re gonna put out money for IVF to go to Dr. Jacobs. We’re not fully done with all the stuff we need to do with him but so far his staff has been wonderful and so is he. He’s gone above and beyond our expectations for IVF. We wish we would’ve started with him.
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Christine
2/14/2025
From the moment I entered Dr. Jacob’s office, I felt reassured that I was in capable hands. The first step was surgery to get rid of cysts, fibroids, scar tissue, and a fallopian tube. My husband and I appreciated Dr. Jacob for being so transparent and let us know that IVF would be our best bet to starting a family and to try immediately after surgery because the endometriosis will grow back in a matter of 6 months. We did not take Dr. Jacob’s advice right away and thus had to undergo a second surgery. We knew that after this second surgery it was go time and so thus our IVF journey began. Miraculously, on our first attempt, we were blessed with a healthy embryo. Now, as we celebrate our second trimester, we can hardly contain our excitement to meet our little one. We are incredibly grateful to Dr. Jacob for his dedication and support throughout our IVF process. He was straightforward and addressed all our concerns with patience, and his expertise ensured both surgeries went smoothly. I also want to give a special shout-out to Ashley, who uplifted our spirits during tough times, often without realizing how much we needed it. Her positivity, and willingness to answer my countless questions were invaluable. I really should get a shirt that says, “I have another question!” Lastly, I can’t forget the wonderful Kaitlyn and Callie, who always brought joy and appreciated my IVF shirts that I would wear to the office. This journey was challenging so coming into the office with cute outfits was always so fun! I looked forward to their calls reminding me of appointments and other important updates. They were also fantastic at teaching us how to administer the medications. We truly couldn’t have navigated this without the entire team, who have now become like family to us. As a first-time IVF patient, stepping into this process felt like a leap of faith, and we are deeply thankful to Dr. Jacob, Ashley, Kaitlyn, and Callie. You are all truly AMAZING!
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Alexandra Theisen
12/25/2024
My husband and I are extremely grateful for the care we received from Dr. Jacob and the staff at CRMRS. We had previously seen a separate fertility specialist who had not completed a thorough workup. Once we transferred care to Dr. Jacob, due to his due diligence he found the reason behind our infertility issues (stage 4 endometriosis) and treated appropriately. Throughout our fertility journey we had multiple episodes where we had to call after hours and we always received prompt and efficient care, even late in the night. CRMRS provided us with an appropriate amount of hope but also realistic expectations based on our personal situation, which is exactly what excellent medical care should provide.
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S G
6/10/2024
Everyone at CRMRS is absolutely amazing. Dr. Jacob and Ashley are incredibly passionate about giving families hope and guidance through their entire fertility journey. Knowing I had such an amazing team leading me along made the high parts that much better and the low parts bearable. No one will go to bat for you more than this team!! I first went to Dr. Jacob with a referral from my OB to help treat my endometriosis. Dr. Jacob was able to remove a lot of endometriosis and diagnose me with Stage 4. My end goal was to have a baby and he and Ashley went through all the steps, meds, outcome percentages, everything. I felt very informed through the entire process. Dr. Jacob ended up doing two robotic surgeries and I went through two rounds of IVF and got pregnant! After years of doctors telling me it couldn’t happen, Dr. Jacob gave me hope that it still could. Thank you thank you thank you for my sweet baby angel! 🌹
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Caryl M Anongos Dominguez
1/17/2024
I could not be any more happier and satisfied with the care I receive from Dr. Jacob and his team. It was a long journey, but I finally ended up pregnant with twins. They explained and educated me on the process very well which made the whole experience relatively stress free. They were very responsive to my questions and concerns and I could not ask for a better team. Ashley and Isabelle were kind and great! They always made me comfortable at every visit. I am eternally grateful for making our dreams of having a family come true.
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Honesty Hope
11/17/2023
I’m not even sure where to begin other than we are so thankful for Dr. Jacob’s and staff 5 stars is just not even enough, I’m thankful for his staff at Center for Reproductive Medicine and Robotic Surgery CRMRS of Missouri they are the most empathetic, caring individuals I’ve ever met! Very professional in every way possible!Myself and my husband gained another family through this office! I couldn’t recommend any other fertility clinic after being with this clinic! Going through fertility issues is so hard and to know you have a whole staff that will hold and hug you through the whole thing is so refreshing. This is literally about you and that’s exactly what they make it about! Dr. Jacob’s is the most kind hearted person I’ve ever met on our journey, he was very honest about what needed to be done and the best method to do it, he is literally there for YOU! And Ashley she is the best cheerleader a girl can ask for she even gave me her cell number for after hour stresses, we couldn’t have asked for better people to help us extend our family, and our first try at IVF through this clinic we are 3 months pregnant with twins on the way and we have been with this clinic for a year this month 10/19/23 WOW right we couldn’t be more blessed by this team! A little history we started our journey about 3 years ago in Dr. Silbers care he filled us up with all his famous stories took all of our money performed procedures come to find out he wasn’t licensed to do! Did egg retrievals he endlessly charged an arm and leg for with no intentions of it working, that he labeled cyst removals, he threw possible good embryos away I’ll never know! He never communicated with us other then at the procedure, his staff was rude disrespectful and also lied about the procedures taking place!Just please don’t ever go to Dr. Silber he is very fraudulent! Dr. Jacob’s office is literally the real deal and his staff is so amazing, if you want to start your family or extend your family Dr. Jacobs at CRMRS is were it’s gonna happen! Give them a call I promise you won’t regret it
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jay wilk
10/17/2023
Want to start off by saying thank you to Dr Jacobs !! I had a huge fibroid that was the size of an 32 week baby! My previous doctor told me that it had gotten so big that could no longer do the procedure i was recommended to Dr Jacobs right away. Nervous because i had never had any type of surgery’s , Dr Jacobs insured me that this would be a breeze for him(but not in those words lol) he is a man of few words but everything he says is powerful. He is very attentive and will make sure he does everything to help you. His staff is even great Ashley became my best friend(sweetest lady ever) and Cali help me out every time i needed her! Thank you Thank you Thank you. I’m still on bed rest but i couldn’t wait to do this review. Back to sleep i go! Jazz! ( i may add phots later)
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Tory Pope
9/17/2023
Dr. Jacob and his team, espically Ashley are amazing. I can’t thank them enough for giving me what I always wanted-a baby.
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Ovarian Cyst Surgery With One Consistent Doctorand a Fertility First Team
What Is an Endometrioma?
An endometrioma is a cyst that forms on the ovary when tissue similar to the lining of the uterus grows where it should not. It is sometimes called a chocolate cyst because of the dark fluid inside. Endometriomas can cause pelvic pain, painful periods, and difficulty getting pregnant, and they can quietly affect the health of the ovary over time.
When an endometrioma needs surgery, the approach matters. At GoFertility the goal is to remove the cyst while keeping the ovary intact whenever it is safe to do so.
Two Ways to Treat an Endometrioma
There is more than one way to handle an ovarian endometrioma in surgery. The two approaches lead to very different outcomes for your ovary and your future fertility.
Removing Only the Cyst (Ovarian Cystectomy)
Dr. Jacob carefully separates the endometrioma from the healthy ovary and removes the cyst, leaving the ovary in place. This preserves ovarian tissue and helps protect your egg supply.
Why this matters
Keeping the ovary protects your natural hormone production and your ovarian reserve, which is the number of eggs you have. For patients who hope to conceive now or later, including through IVF, preserving that reserve can make a meaningful difference.
In some settings, an endometrioma is treated by removing the entire ovary along with the cyst. It can be a faster operation, but it means the loss of that ovary and the eggs it holds.
When is it needed
There are real situations where removing the ovary is the safest choice, such as very large or complex cysts or specific medical concerns. Dr. Jacob will always tell you honestly if that is the case for you. The point is that it should be a considered decision, not the automatic one.
Your ovaries do two important jobs. They hold your eggs and they produce the hormones that support your cycle and your overall health. When the whole ovary is removed, both of those are affected. By removing only the endometrioma and leaving healthy ovarian tissue in place, Dr. Jacob works to protect your fertility and your natural hormone balance for the long term.
What To Expect Step By Step
Schedule Your Consult with Dr. Jacob
You start by either calling our office at 314-473-1285 or by filling out the form on this page. These visits are usually available within a week. During the consult you talk through your symptoms, your goals, your medical history, and how the process works. This first visit sets the plan for everything that comes next.
Imaging and Ovarian Reserve Testing
A pelvic ultrasound helps map the size and position of the endometrioma. When fertility is part of your goals, Dr. Jacob may also review markers of ovarian reserve so that the surgical plan is built to protect your egg supply as much as possible.
Surgical Planning
Dr. Jacob explains the recommended approach for your case, with the aim of removing the cyst and keeping the ovary. You review the expected benefits, the risks, and the recovery time together. Then a surgery date is scheduled and you receive clear instructions for the days beforehand.
Day of Surgery
The endometrioma is removed through small incisions using minimal access and robotic techniques whenever it is safe. Dr. Jacob and the operating room team guide you through each step and monitor you closely. Many patients go home the same day depending on complexity and their health.
Recovery and Follow Up
You receive clear instructions for comfort, activity, and follow up visits. Many patients are up and moving around the house within a few days, with fuller recovery over the following weeks. For those planning IVF or other fertility treatment, Dr. Jacob will explain when it is safe to move to the next step.
Why Choose GoFertility for Endometrioma Surgery?
You will see Dr. Saji Jacob at every key appointment. You are not just a number to us, and your fertility is part of the plan from the very first visit.
A focus on keeping your ovary
Dr. Jacob works to remove the endometrioma while preserving healthy ovarian tissue, rather than removing the ovary as a default.
You see Dr. Jacob at every key visit
From the first consult through your follow up visits, you work directly with the same physician.
Proven experience in complex cases
Dr. Jacob has performed more than 1,000 robotic and complex minimally invasive surgeries for endometriosis, cysts, fibroids, and related conditions.
Integrated surgery and fertility care
Because GoFertility also runs a full IVF and lab program, your surgery plan is built with your fertility goals in mind.
Success Rate
We are very proud to announce our overall pregnancy per embryo transfer success rate….
Can an endometrioma be removed without taking the ovary?
In most cases, yes. Dr. Jacob focuses on removing the cyst while keeping the healthy ovary in place. There are situations where removing the ovary is the safest option, and he will explain clearly if that applies to your case.
Will keeping the ovary help my fertility?
Preserving healthy ovarian tissue helps protect your egg supply and your natural hormones. For patients hoping to conceive, now or in the future, that can be an important part of the plan. Dr. Jacob will talk through what your results mean for your goals.
Is the surgery minimally invasive?
Dr. Jacob performs most endometrioma surgeries as an outpatient procedure at the hospital, using small incisions with minimal access or robotic techniques. This can mean less pain, lower risk of infection, less scarring, and a faster return to daily life. Most patients go home the same day. Dr. Jacob will explain which method is recommended for you.
How long does recovery take?
Recovery depends on the size and complexity of the cyst and your overall health. Many patients return to light daily tasks within a few days and feel steadily better over the following weeks. You will receive a clear timeline before your procedure.
Is a robot operating on me during robotic surgery?
No. The robot does not move or make decisions on its own. Dr. Jacob is at the console in the operating room, in full control of every movement. The system simply helps translate his hand motions into very small, precise movements inside the body. Learn More.
Is surgery covered by insurance?
Coverage varies by plan and diagnosis. Our team can offer basic guidance, and we always encourage patients to call their insurance provider directly to confirm benefits before scheduling surgery.
agraham@gofertility.com
844 North New Ballas Court, Suite 300, St. Louis, MO 63141
