In this episode of Talking O&G, host Dr Heather Waterfall is joined by Associate Professor Mathew Leonardi to answer RANZCOG members’ and trainees’ questions on endometriosis. An internationally recognised leader in gynaecological surgery and ultrasound, Mathew is an Associate Professor at McMaster University Medical Centre in Hamilton, Canada, and holds a PhD from the University of Sydney. He sits on the World Endometriosis Society Early Career Board and is a founding member of the Next Generation Committee at the International Society of Ultrasound in Obstetrics and Gynaecology. During the discussion, Mathew weighs in on the shift towards ultrasound as the preferred first-line diagnostic tool for endometriosis, the benefits and limitations of this method, how MRI compares, and recommendations for laparoscopy as a surgical intervention. Mathew also advocates for upskilling both gynaecologists and sonographers in advanced gynaecological ultrasound, the importance of ‘prehab’, and how to support patients with endometrioma who are seeking fertility. 🔗 Resources mentioned in this episode: Talking O&G E4. Unpacking RANZCOG’s New Endometriosis Guideline Australian Living Evidence Guideline: Endometriosis Patient resources: https://ranzcog.edu.au/womens-health/endometriosis/ 📌 RANZCOG members can submit CPD at: https://shorturl.at/iq733 💬 If you found this episode valuable, please rate, review, subscribe, and share it with your colleagues. RANZCOG acknowledges the need for more inclusive terminology for gender diversity.  In this podcast we aim to use inclusive language, and any use of the term “women” should be interpreted to include all people requiring gynaecological and obstetric care.   The views expressed are those of the speakers and may not reflect the official position of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). COI Statement: Mathew Leonardi reports grants from Australian MRFF, AbbVie, AIMA/SOPHIE, CanSAGE, CIHR, Endometriosis Australia, Hamilton Health Sciences, Health Canada, Hyivy/MITACS/SOPHIE, Medical Research Future Fund/Imagendo, Myant Inc/MITACS, GE HealthCare/MITACS, and Pfizer; honoraria for lectures/writing from AIUM, AbbVie, Bayer, Canon, GE Healthcare, Pfizer, Samsung, TerSera; consultancy work with AbbVie, Chugai, Gesynta, Hologic, Imagendo, Pfizer, and Roche Diagnostics; and affiliations with SUGO (Specialized Ultrasound in Gynecology & Obstetrics) and Endometriosis360. He holds leadership roles in the World Endometriosis Society Early Career Board, ISUOG Next Generation, and the Gynecologic Ultrasound Society, all outside the submitted work.