A 32-year-old nulliparous woman presents with severe dysmenorrhea and chronic pelvic pain for 3 years. Transvaginal ultrasound shows multiple cystic lesions in both ovaries with heterogeneous echogenicity and normal endometrial thickness. There is no adenomyosis on imaging. She has tried NSAIDs and combined oral contraceptives for 6 months without significant relief. What is the most appropriate next step in management?