Endometriosis classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2]

Overview

Endometriosis is classified into four stages of severity based on the revised American Society for Reproductive Medicine scoring system. The staging is based on the distribution of the lesions and the presence of adhesions.

Classification

Endometriosis is classified based on the revised American Society for Reproductive Medicine scoring system:

• Stage I:
  • Minimal disease
  • Lesions isolated and limited to the pelvis
  • No adhesions present
• Stage II:
  • Mild endometriosis lesions are superficial with size less than 5 cm on aggregate
  • Lesions scattered on the peritoneum and ovaries
  • No significant adhesions present
• Stage III:
  • Moderate disease characterized by the presence of multiple implants
  • Includes both superficial and deeply invasive lesions
  • Peritubal and periovarian adhesions may be evident
• Stage IV:
  • Severe disease characterized by multiple superficial and deep implants
  • Large ovarian endometriomas
  • Dense adhesions present