Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Endometriosis classification: an update

Adamson, G. David

Current Opinion in Obstetrics and Gynecology: August 2011 - Volume 23 - Issue 4 - p 213–220
doi: 10.1097/GCO.0b013e328348a3ba
Reproductive endocrinology: Edited by David L. Olive

Purpose of review Endometriosis remains an enigmatic disease for many reasons, not the least being a continued inability to stage its clinical presentation so that prognosis and treatment for both pain and infertility patients can be facilitated. This article reviews issues with current staging systems.

Recent findings The revised American Fertility Society (rAFS) classification system has historically been the only classification system. Recently, the ENZIAN classification system, developed as an adjunct to the rAFS to describe more severe disease, has been introduced but is rarely used. More recently, the Endometriosis Fertility Index (EFI) that has been validated to predict pregnancy rates in infertility patients following surgical diagnosis and treatment of endometriosis was published. Currently, the AAGL is developing a categorization system that will be more focused on pain. Novel research in imaging, biomarkers, histology, and the human genome may provide useful information to develop future classification systems.

Summary The only validated endometriosis classification system that predicts a clinical outcome is the EFI. It is to be hoped that renewed interest in the importance and utility of classification systems will result in novel classification systems that are clinically useful.

Fertility Physicians of Northern California, San Jose and Palo Alto, California, USA

Correspondence to G. David Adamson, 540 University Avenue, Suite 200, Palo Alto, CA 94301, USATel: +1 650 322 1900; e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.