Hmm.. it's really your choice whether to have the surgery to diagnose. If you're in a lot of pain then I'd say it's worth having surgery, but have an endometriosis specialist do it, not your regular OBGYN. That way you get it both diagnosed & thoroughly removed in one surgery, instead of having a surgery with an OBGYN with a lower skill level to diagnose it, since they're very likely to leave a lot of the tissue inside, & then you could potentially need to have an additional surgery with an expert later for a more thorough removal.

It's always best if you can minimize the number of surgeries & get expert care from the start, since every surgery does create scar tissue which can cause pain & sometimes cause difficulty getting pregnant (but not always). It's also important to realize that endometriosis itself creates scar tissue & can affect fertility as well. And it can continue to grow while you're on birth control and during pregnancy.

Bottom line is that it's always a good idea to reach out to an endometriosis specialist for advice about this disease because it's difficult to treat & they have much more up to date education & training than your average OBGYN 🙂