Final answer:
The optimal management for a reproductive-age woman with an endometrial polyp larger than 2cm who desires fertility is the surgical removal of the polyp through a hysteroscopic polypectomy to maintain fertility, possibly followed by in vitro fertilization if needed.
Step-by-step explanation:
The best management option for an endometrial polyp that is more than 2cm in a reproductive-age woman who desires fertility is typically surgical removal. This can be done through a procedure known as hysteroscopic polypectomy, where the polyp is excised while preserving the uterus and maintaining the woman's fertility. This is the preferred approach because endometrial polyps can be associated with infertility, and their removal may improve fertility outcomes. After the surgical management of the polyp, a woman may opt for in vitro fertilization (IVF) if there are additional fertility issues, or proceed with attempts to conceive naturally if there are no other fertility concerns. In some cases, hormonal treatments might be utilized to treat associated conditions that can affect fertility, like ovulation disorders.