The classification system
Stage I (minimal): superficial implants, mild adhesions. Stage II (mild): more extensive superficial lesions. Stage III (moderate): deep implants, mild adhesions, ovarian involvement. Stage IV (severe): deep implants, dense adhesions, large endometriomas.
What ASRM does not capture
Pain severity does not correlate with stage – a woman with stage I disease can have severe pain. Bowel and bladder involvement are not well captured. Fertility impact varies independently of stage. Newer #Enzian system better captures deep disease.
Clinical use
Standardised communication between specialists. Surgical planning. Research and outcome comparison. Counselling about overall disease burden. Useful but not the only metric for treatment decisions.
Frequently asked
Dr. Priyadatt Patel
Senior Gynecologist · Advanced Laparoscopic Surgeon · IVF and Endometriosis Programme Lead
MS OBGyn · Pregnancy Care · Advanced Gynaecological Ultrasound · Fertility Preservation
ESHRE / ESGE / AAGL / ASRM guideline-aligned practice. 3D Karl Storz precision technique. Fertility-preservation-first philosophy. Evidence-based decisions, honest counselling, long-term outcomes orientation.
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