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.

StageAmerican 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 ClassificationDescription
Early peritoneal endometriosis
  • Infiltration to the lining of the abdomen (peritoneum)
Ovarian endometriomas
  • Large, "chocolate" fluid-filled cysts that form on, and even encapsulate, the ovaries
Cul-de-sac obliteration
  • Infiltration of the tissue lining the back wall of the uterus and rectum (cul-de-sac), an extension of the peritoneum
Deep infiltrating endometriosis (DIE)
  • Invasive endometriosis that penetrates to the bladder and bowel wall
Frozen pelvis
  • Rare condition, in which there are deep infiltrative attachments to pelvic ligaments, nerves and muscle tissue that partially or totally cements pelvic organs

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.

Our office is located on 872 Fifth Avenue New York, NY 10065.
You may call us at 212-988-1444 or have your case reviewed by clicking here.

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What is endometriosis?<br /> Stages, Symptoms, Causes, Diagnosis and Treatment
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
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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Patient Reviews

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  • Angela Aro

    I have struggled with endometriosis and adenomyosis since first starting my period at 13. I was diagnosed at 21 and what followed was a series of unsuccessful surgeries and treatments. My case was very aggressive and involved my urinary tract system and my intestines. After exhausting all of my local doctors I was lucky enough to find Dr. Seckin. We…

  • Emi O

    Seckin and Dr. Goldstein changed my life!

  • Kristin Sands

    Like so many women who have tirelessly sought a correct diagnosis and proper, thorough medical treatment for endometriosis, I found myself 26 years into this unwanted journey without clear answers or help from four previous gynecological doctors and two emergency laparoscopic surgeries. I desperately wanted to avoid the ER again; a CT scan for appendicitis also revealed a likely endometrioma…

  • Wilfredo Reyes

    Dr. Seckin literally gave my wife her life back. I am eternally grateful to him for his generous, determined spirit to see that Melanie finally live free from the prison bonds of Endometriosis.

  • Carla

    I am so grateful to Dr Seckin and Dr. Goldstein. My experience was nothing short of amazing. I was misdiagnosed with the location of my fibroids and have had a history of endometriosis. Dr. Seckin was the one who accurately diagnosed me. Dr Seckin and Dr. Goldstein really care about their patients and it shows. They listened to my concerns,…

  • Melissa Boudreau

    When I think of Dr. Seckin these are the words that come to mind. Gratitude, grateful, life-changing, a heart of gold. I feel compelled to give you a bit of background so you can understand the significance of this surgery for me. I am passionate about Endometriosis because it has affected me most of my life and I have a…

  • Jaclyn Harte

    Dr. Seckin and Dr. Goldstein radically changed my quality of life. They treat their patients with dignity & respect that I've personally never seen in the literally 25+ doctors I've seen for endometriosis. This summer, I had a surgery with Dr. Seckin & Goldstein. It was my first with them, but my 5th endo surgery. I couldn't believe the difference,…

  • Megan Rafael Moreno

    I was in pain for 2 years. I was getting no answers, and because dr Goldstein and dr seckins were willing to see and treat me I'm finally feeling almost back to normal. They were very down to earth and helpful in my time of need. Dr Goldstein was easy to talk to and caring, she took care of me…

  • Nancy Costa

    Dr. Seckin is one of the best endometriosis surgeon. Every time I go to the office, he really listens to me and is always concerned about my issues. Dr Seckin's office staff are a delight and they always work with me. I feel I can leave everything to them and they will take care of it. Thank you to the…

  • Rebecca Black

    Fast forward 5 years to find out incidentally I had a failing kidney. My left kidney was only functioning at 18%. During this time, I was preparing all my documents to send to Dr. Seckin to review. However, with this new information I put everything on hold and went to a urologist. After a few months, no one could figure…

  • Monique Roberts

    I'll never stop praising Dr. Seckin and his team. He literally gave me back my life.

  • Erin Brehm

    I had a wonderful experience working with Dr. Seckin and his team before, during and after my surgery. I came to Dr. Seckin having already had laparoscopic surgery for endometriosis 5 years prior, with a different surgeon. My symptoms and pain had returned, making my life truly challenging and my menstrual cycle unbearable. Dr. Seckin was quick to validate my…

  • Anita Schillhorn

    I came to Dr. Seckin after years of dealing with endometriosis and doctors who didn't fully understand the disease. He quickly ascertained what needed to be done, laid out the options along with his recommendation and gave me the time to make the right decision for me. My surgery went without a hitch and I'm healing very well. He and…

  • Nicholette Sadé

    Dr. Seckin brought me back to life! I am now 3 weeks into my recovery after my laparoscopy surgery, and I feel like a new and improved woman! Being diagnosed with Endometriosis, then 25yrs old in 2015, and discovering the severity of my case being stage 4, made me devastated. Dr. Seckin's vast knowledge of the disease, sincere empathy, and…