Hi!
I am a little confused because endometriosis is not normally visible on ultrasound. A laparoscopy is almost always necessary. It certainly is possible that you do indeed have endometriosis, and that the symptoms were blunted by the oral contraceptives.
Many women who have been long term OC users find their natural periods quite heavy, and uncomfortable. Endometriosis can contribute to infertility, and can increase the risk of miscarriage. Studies are mixed as to whether treatment by laser or other surgery improves conception rates. Certainly, if the endometriosis has affected the tubes, removal of blockage or adhesions improves fertility.
Because you were able to successfully conceive once, there is a good chance that you will be able to do so again--and most likely with a better result in the next pregnancy.
If you were my patient I would base my decision to operate based on how painful your cycles were--surgery does improve pain. Also, if you had a second miscarriage, I would strongly consider surgery too.
Hope this helps!
Dr B
I know the first cycle after I had mine removed, we did medication only and got pg. first try, I am now 18w5d. In my case it was definately a problem because we tried for over a year. Good luck to you.