The revised American Society for Reproductive Medicine (rASRM) staging of endometriosis assigns additional points for which ovarian endometrioma feature compared to a peritoneal implant of the same size?
- A Ovarian endometriomas only score points if they exceed 3 cm in diameter
- B Deep ovarian endometriomas receive higher point scores than superficial peritoneal implants of equivalent size ✓
- C Peritoneal implants and ovarian endometriomas are scored identically
- D Ovarian endometriomas < 3 cm receive the same score as peritoneal implants
Correct answer: B. Deep ovarian endometriomas receive higher point scores than superficial peritoneal implants of equivalent size
Explanation
In the rASRM scoring system, deep endometriomas (defined as > 3 cm) receive substantially higher point values (16–20 points) compared to superficial peritoneal implants of the same size, reflecting their greater impact on ovarian reserve and fertility. Peritoneal implants are scored 1–4 points depending on depth. Adhesion scores are added separately. This weighting toward ovarian involvement distinguishes severe disease (Stage III–IV) from superficial peritoneal disease.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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