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. 2021 Jan;38(1):10-18.
doi: 10.12701/yujm.2020.00444. Epub 2020 Aug 7.

Classification of endometriosis

Soo-Young Lee  1 , Yu-Jin Koo  2 , Dae-Hyung Lee  2
Affiliations

Classification of endometriosis

Soo-Young Lee et al. Yeungnam Univ J Med. 2021 Jan.

Abstract

Endometriosis is a chronic disease associated with pelvic pain and infertility. Several classification systems for the severity of endometriosis have been proposed. Of these, the revised American Society for Reproductive Medicine classification is the most well-known. The ENZIAN classification was developed to classify deep infiltrating endometriosis and focused on the retroperitoneal structures. The endometriosis fertility index was developed to predict the fertility outcomes in patients who underwent surgery for endometriosis. Finally, the American Association of Gynecological Laparoscopists classification is currently being developed, for which 30 endometriosis experts are analyzing and researching data by assigning scores to categories considered important; however, it has not yet been fully validated and published. Currently, none of the classification systems are considered the gold standard. In this article, we review the classification systems, identify their pros and cons, and discuss what improvements need to be made to each system in the future.

Keywords: American Society for Reproductive Medicine classification; Classification; ENZIAN classification; Endometriosis.

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Conflict of interest statement

Conflicts of interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
The revised American Society for Reproductive Medicine classification of endometriosis. This system is the well-known classification of endometriosis. Reproduced from American Society for Reproductive Medicine [8] with permission of Elsevier.
Fig. 2.
Fig. 2.
The ENZIAN staging system for women with deep endometriosis. This system was developed as a supplement to the revised American Society for Reproductive Medicine score, in order to provide detailed descriptions of the retroperitoneal structure. Adapted from 7th Conference of the Stiftung Endometriose Forschung [16] (https://www.endometriose-sef.de/aktivitaeten/klassifikation-enzian/).
Fig. 3.
Fig. 3.
Endometriosis fertility index (EFI) system. This score predicts the fertility outcome for women who attempt non-in vitro fertilization conception following surgically documented endometriosis. Reproduced from Adamson and Pasta [20] with permission of Elsevier.
See this image and copyright information in PMC

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