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There is a need to move beyond pilot-scale studies to multicenter, randomized, double-blind, placebo-controlled trials with adequately powered sample sizes, extended follow-up (≥24 months), and standardized, clinically validated endpoints, including pain assessment (VAS/NRS), fertility outcomes (time-to-pregnancy, live birth rates), lesion volume quantification using MRI, and quality-of-life measures such as ENDO-QoL