Complete loss of function in both ovaries due to tissue shrinkage.
To support a 20% rating for complete atrophy of both ovaries, your records should show that both ovaries have completely atrophied. Medical records from a gynecologist or other treating provider documenting the diagnosis and confirming the bilateral, complete nature of the atrophy are central to this. Imaging studies such as ultrasound or other diagnostic imaging that show the size and condition of both ovaries can directly reflect the degree of atrophy.
Operative reports or pathology records are relevant if the atrophy resulted from surgery or a medical procedure. Hormone panel results showing the loss of ovarian function may help corroborate the clinical picture. Statements from you describing how your symptoms affect your daily life and work can provide context, though the rating itself turns on the confirmed clinical finding of complete bilateral atrophy rather than on symptom severity. Records that document chronic residuals of any surgical or medical complications may also be relevant depending on your circumstances.
Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.