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What are the 4 stages of endometriosis?

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4 fertility expert(s) answered this question

Answer from: Luciano Nardo, MD, MRCOG

Gynaecologist, Subspecialist in Reproductive Medicine, CEO & Founder, NOW-fertility
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There are four stages of endometriosis, that is the classification according to the American Society for Reproductive Medicine and the first stage is stage I which is minimal endometriosis, stage II which is mild endometriosis, stage III which is moderate endometriosis and stage IV which is severe endometriosis. The stages of endometriosis are defined according to the extension of the disease so more organs are involved and then obviously more severe is the endometriosis. However, there is a debate with regards to the relationship between the stage of endometriosis and the symptoms of endometriosis. Although it is possible to speculate and accept that and most viewers the disease inversely severe would be the symptoms sometimes, women with very early stages disease such as stage I and stage II may experience some significant symptoms such as pelvic pain, painful intercourse painful periods.

Answer from: Sibte Hassan, MBBS, FCPS, MRCOG, MSc

Gynaecologist, Fertility specialist and Gynaecologist at London Womens Clinic
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The first stage is minimal stage – I, the other one is mild which is stage II, third one is moderate which is stage III and fourth one is severe which is stage IV. It’s basically dependent on the size of the endometriotic line and deposit, it also depends on the depth, it also depends on whether we find the scar tissue and different tissues are adherent together or not and the size of the disease as well whether it involves the tubes, how many deposits, whether it is on one side or both sides. So, the more the liens are, the more the scar tissue is, the more the amount of the diseases, the stage will go up and up.

Answer from: Ahmed Elgheriany, MRCOG, MD, MSc

Gynaecologist, Fertility Specialist GENNET City Fertility
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Stages of endometriosis is quite difficult to set a different a real stages for endometriosis because it’s different between one to another but generally, we can classify it into like: I, II, III, IV or superficial endometriosis, endometrioma, deep infiltrating endometriosis. Superficial endometriosis, if we will go with stage one, it will just minimal spots of this endometrial gland inside the tummy or onto the ovaries, uterus ligament or into the back of the womb itself and to the vagina. It’s very superficial and it’s less than half centimetre in vision or one centimetre in vision. This is superficial endometriosis or stage I endometriosis.
Stage II endometriosis, it will be much more in depth and much more distributed in your body and can reach to areas outside the pelvis but it’s not that severe.
Stage III endometriosis, it will start to go much more deeper and you will find some adhesions in your pelvis and could affect the ovary and start to have what we are calling endometrioma or endometrial gland which forms cysts inside the ovary itself.
Stage IV endometriosis, it’s just going with deep infiltrating endometriosis and here your body will start to form nodules and this endometriosis ground will start mountains below the lining of your womb and between the colon, sometimes in the colon, sometimes in the rectum and the vagina which is very common place. Sometimes it could affect the bladder, sometimes it could affect the ureter so, it’s very strange and sometimes could implant it into the diaphragm and/or into the lung. So, this is a stage for endometriosis and causing many many health problems.

Answer from: Andrew Horne, Professor

Gynaecologist, Co-Director EXPPECT Edinburgh, Chair of Academic Board RCOG, Professor of Gynaecology and Reproductive Sciences at The University of Edinburgh 
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Stages of endometriosis are: stage I which is minimal disease, stage II which is mild disease, stage III which is moderate disease and stage IV which is severe disease and the definitions about what constitutes these different stages are really to do with the appearance of the disease and where it’s found. There’s a scoring system which surgeons will use when they look at the disease, when they’re operating and that’s how we get to these different numbers.

About this question:

What are the stages of endometriosis?

Endometriosis is a painful condition in which tissue similar to the uterus tissue — the endometrium — grows outside your uterus. To properly determine the stage or severity of endometriosis, a key hole surgery is needed. How is it precisely described?

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