Clinical Characteristics of Unilateral versus Bilateral Ovarian Endometriomas and Risk Stratification in Stage IV Disease Using the rASRM Score: A Retrospective Cohort Study from a Tertiary Medical Center

Background

Endometriomas are a common manifestation of endometriosis and can present as unilateral or bilateral disease. While bilateral involvement is clinically suspected to reflect more severe disease and greater impairment of ovarian reserve, the specific phenotypic differences and their implications for surgical complexity and fertility preservation remain insufficiently characterized. This study aimed to compare the clinical characteristics of unilateral vs bilateral endometriomas and to explore risk stratification within Stage IV disease using the revised American Society for Reproductive Medicine (rASRM) score.