Stages of Endometriosis
OVERVIEW
What are the stages of endometriosis?
Endometriosis is classified into four stages; I-minimal, II-mild, III-moderate, and IV-severe. Staging has been defined by the American Society for Reproductive Medicine (ASRM), with criteria based on the location of the disease, extent, depth of endometriosis implants, presence and size of ovarian endometriomas, and the presence and severity of adhesions.
| Stage | American Society of Reproductive Medicine Severity Classifications |
|---|---|
| Stage I | Mild |
| Stage II | Minimal |
| Stage III | Moderate |
| Stage IV | Severe |
How are these stages of endometriosis assigned?
These criteria that make up the stages of endometriosis are graded on a point system to determine classification. First developed in 1973, the classification scheme has been revised and refined three times for a more precise method of documentation. A score of 1-15 indicates minimal or mild endometriosis, while a score of 16 or higher indicates moderate to severe.
What is the problem with this method of classification?
The scoring and stage of the disease are not indicative of the pain level. Instead, this system was fundamentally developed as an indicator of endometriosis-associated infertility, and, therefore, has no specific correlation to any symptoms. This means that a woman in stage IV can be asymptomatic, while a stage 1 patient might be in debilitating pain.
Our Approach
What is the best way to obtain a thorough classification of endometriosis?
For an accurate diagnosis, a direct visual inspection inside of the pelvis and abdomen, as well as tissue biopsy of the implants are necessary. A pathologist will observe the obtained biopsy sample under a microscope in order to view any inflammatory changes or signs of cancer, which they will then report back to the surgeon. This ultimately allows your surgeon to gain a better understanding of the extent of your disease and thus provide a more descriptive classification of your particular case of endometriosis.
What are our “Descriptive Classifications of Endometriosis?”
Due to all the factors mentioned above, your normal one through four classification of endometriosis may be of less significance than our “Descriptive Classifications.” This represents four different forms of the disease that must be considered: peritoneal disease, ovarian endometrioma, deep infiltrating endometriosis (DIE) and Frozen Pelvis. Though different, they are not altogether clinically distinct, and the pathophysiological mechanisms involved in all four remain poorly understood.
| Dr. Seckin’s Prefered Classification | Description |
|---|---|
| Early peritoneal endometriosis |
|
| Ovarian endometriomas |
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| Cul-de-sac obliteration |
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| Deep infiltrating endometriosis (DIE) |
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| Frozen pelvis |
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For patients suffering from endometriosis, it is crucial to monitor and keep in my mind the extent of your symptoms and the disease itself. It is disheartening to hear when patients feel they need to mask their suffering and are told by their physician that their pain is simply “emotional stress.” We believe that you deserve the care and attention that a complicated disease such as endometriosis deserves. This includes opening up a personal, private discussion to the descriptive classification and extent of which you may be suffering from endometriosis.
You may call us at 212-988-1444 or have your case reviewed by clicking here.
What is endometriosis?
Stages, Symptoms, Causes, Diagnosis and Treatment
OVERVIEW
What is Endometriosis?
Endometriosis is a female disease in which endometrial-like tissue is found outside of the uterus in…
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Peritoneal Endometriosis
Overview
The present classification of endometriosis is defined by the American Society of Reproductive Medicine for patients who have fertility…
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