Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec;13(4):295-304.
doi: 10.52054/FVVO.13.4.036.

An International Terminology for Endometriosis, 2021

International Working Group of AAGL, ESGE, ESHRE and WES; C Tomassetti, N P Johnson, J Petrozza, M S Abrao, J I Einarsson, A W Horne, T T M Lee, S Missmer, N Vermeulen, K T Zondervan, G Grimbizis, R L De Wilde

An International Terminology for Endometriosis, 2021

International Working Group of AAGL, ESGE, ESHRE and WES et al. Facts Views Vis Obgyn. 2021 Dec.

Abstract

Background: Different classification systems have been developed for endometriosis, using different definitions for the disease, the different subtypes, symptoms and treatments. In addition, an International Glossary on Infertility and Fertility Care was published in 2017 by the International Committee for Monitoring Assisted Reproductive Technologies (ICMART) in collaboration with other organisations. An international working group convened over the development of a classification or descriptive system for endometriosis. As a basis for such system, a terminology for endometriosis was considered a condition sine qua non.

Objectives: The aim of the current paper is to develop a set of terms and definitions on endometriosis that would be the basis for standardisation in disease description, classification and research.

Materials and methods: The working group listed a number of terms relevant to be included in the terminology, documented currently used and published definitions, and discussed and adapted them until consensus was reached within the working group. Following stakeholder review, further terms were added, and definitions further clarified. Although definitions were collected through published literature, the final set of terms and definitions is to be considered consensus-based. After finalisation of the first draft, the members of the international societies and other stakeholders were consulted for feedback and comments, which led to further adaptations.

Results: A list of 49 terms and definitions in the field of endometriosis is presented, including a definition for endometriosis and its subtypes, different locations, interventions, symptoms and outcomes. Endometriosis is defined as a disease characterised by the presence of endometrium-like epithelium and/or stroma outside the endometrium and myometrium, usually with an associated inflammatory process.

Conclusions: The current paper outlines a list of 49 terms and definitions in the field of endometriosis. The application of the defined terms aims to facilitate harmonisation in endometriosis research and clinical practice. Future research may require further refinement of the presented definitions.

What is new?: A consensus based international terminology for endometriosis for clinical and research use.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: A.W.H. reports grant funding from the MRC, NIHR, CSO, Wellbeing of Women, Roche Diagnostics, Astra Zeneca, Ferring, Charles Wolfson Charitable Trust, Standard Life, Consultancy fees from Roche Diagnostics, AbbVie, Nordic Pharma and Ferring, outside the submitted work; In addition, Dr. Horne has a patent Serum biomarker for endometriosis pending. N.P.J. reports personal fees from Abbott, Guerbet, Myovant Sciences, Vifor Pharma, Roche Diagnostics, personal fees from Abbott, Guerbet, personal fees from Guerbet, Myovant Sciences, Vifor Pharma, Roche Diagnostics, outside the submitted work; he is also President of the World Endometriosis Society and chair of the trust board. S.M. reports grants and personal fees from AbbVie, and personal fees from Roche outside the submitted work. C.T. reports grants, non-financial support and other from Merck SA, non-financial support and other from Gedeon Richter, non-financial support from Ferring Pharmaceuticals, outside the submitted work and without private revenue. K.T.Z. reports grants from Bayer Healthcare, MDNA Life Sciences, Roche Diagnostics Inc, Volition Rx, outside the submitted work; she is also a Board member (Secretary) of the World Endometriosis Society and World Endometriosis Research Foundation, Research Advisory Board member of Wellbeing of Women, UK (research charity), and Chair, Research Directions Working Group, World Endometriosis Society. The other authors had nothing to disclose.

J.P reports personal fees from Hologic, Inc., outside the submitted work; he is also a memberof the executive boards of ASRM and SRS.

Similar articles

  • An international terminology for endometriosis, 2021.
    International Working Group of AAGL, ESGE, ESHRE and WES; Tomassetti C, Johnson NP, Petrozza J, Abrao MS, Einarsson JI, Horne AW, Lee TTM, Missmer S, Vermeulen N, Zondervan KT, Grimbizis G, De Wilde RL. International Working Group of AAGL, ESGE, ESHRE and WES, et al. Hum Reprod Open. 2021 Oct 22;2021(4):hoab029. doi: 10.1093/hropen/hoab029. eCollection 2021. Hum Reprod Open. 2021. PMID: 34693033 Free PMC article.
  • An International Terminology for Endometriosis, 2021.
    International working group of AAGL, ESGE, ESHRE and WES; Tomassetti C, Johnson NP, Petrozza J, Abrao MS, Einarsson JI, Horne AW, Lee TTM, Missmer S, Vermeulen N, Zondervan KT, Grimbizis G, De Wilde RL. International working group of AAGL, ESGE, ESHRE and WES, et al. J Minim Invasive Gynecol. 2021 Nov;28(11):1849-1859. doi: 10.1016/j.jmig.2021.08.032. Epub 2021 Oct 21. J Minim Invasive Gynecol. 2021. PMID: 34690084 Review.
  • The International Glossary on Infertility and Fertility Care, 2017.
    Zegers-Hochschild F, Adamson GD, Dyer S, Racowsky C, de Mouzon J, Sokol R, Rienzi L, Sunde A, Schmidt L, Cooke ID, Simpson JL, van der Poel S. Zegers-Hochschild F, et al. Hum Reprod. 2017 Sep 1;32(9):1786-1801. doi: 10.1093/humrep/dex234. Hum Reprod. 2017. PMID: 29117321 Free PMC article.
  • The International Glossary on Infertility and Fertility Care, 2017.
    Zegers-Hochschild F, Adamson GD, Dyer S, Racowsky C, de Mouzon J, Sokol R, Rienzi L, Sunde A, Schmidt L, Cooke ID, Simpson JL, van der Poel S. Zegers-Hochschild F, et al. Fertil Steril. 2017 Sep;108(3):393-406. doi: 10.1016/j.fertnstert.2017.06.005. Epub 2017 Jul 29. Fertil Steril. 2017. PMID: 28760517
  • Top 10 priorities for future infertility research: an international consensus development study.
    Duffy JMN, Adamson GD, Benson E, Bhattacharya S, Bhattacharya S, Bofill M, Brian K, Collura B, Curtis C, Evers JLH, Farquharson RG, Fincham A, Franik S, Giudice LC, Glanville E, Hickey M, Horne AW, Hull ML, Johnson NP, Jordan V, Khalaf Y, Knijnenburg JML, Legro RS, Lensen S, MacKenzie J, Mavrelos D, Mol BW, Morbeck DE, Nagels H, Ng EHY, Niederberger C, Otter AS, Puscasiu L, Rautakallio-Hokkanen S, Sadler L, Sarris I, Showell M, Stewart J, Strandell A, Strawbridge C, Vail A, van Wely M, Vercoe M, Vuong NL, Wang AY, Wang R, Wilkinson J, Wong K, Wong TY, Farquhar CM; Priority Setting Partnership for Infertility. Duffy JMN, et al. Fertil Steril. 2021 Jan;115(1):180-190. doi: 10.1016/j.fertnstert.2020.11.014. Epub 2020 Nov 30. Fertil Steril. 2021. PMID: 33272617
See all similar articles

Cited by

See all "Cited by" articles

References

    1. Abrao MS, Neme RM, Carvalho FM, et al. Histological classification of endometriosis as a predictor of response to treatment. Int J Gynaecol Obstet. 2003;82:31–40. - PubMed
    1. Chapron C, Vannuccini S, Santulli P, et al. Diagnosing adenomyosis: an integrated clinical and imaging approach. Hum Reprod Update. 2020;26:392–411. - PubMed
    1. Duffy J, Hirsch M, Vercoe M, et al. A core outcome set for future endometriosis research: an international consensus development study. BJOG. 2020;127:967–974. - PubMed
    1. Heller DS. Lesions of the pouch of douglas: a review. J Minim Invasive Gynecol. 2016;23:28–33. - PubMed
    1. WHO. International classification of diseases and related health problems (ICD-11) 2020

LinkOut - more resources