How is endometriosis staged?

Updated: May 10, 2021
  • Author: G Willy Davila, MD; Chief Editor: Michel E Rivlin, MD  more...
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The American Society for Reproductive Medicine classification of endometriosis is currently the most widely used staging system. [46] Point scores are assigned based on the number of lesions and their bilaterality as well as associated adhesion formation noted at the time of surgery. Lesion size is also a scoring factor. This classification is a fairly accurate method of recording laparoscopic findings. However, high intraobserver and interobserver variability precludes its use in comparing the outcomes of therapeutic studies. [47] Furthermore, this staging system does not correlate well with pain and dyspareunia, [48] and fecundity rates cannot be predicted accurately.

However, the patient's stage (ie, 1-4, or minimal, mild, moderate, and severe) may be useful in determining her prognosis for subsequent reproduction. The staging system can also be used to monitor a patient's response to therapeutic efforts. Surgical exploration is required for this staging system, both initially and for subsequent follow-up; a discussion of its details is beyond the scope of this article.

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