Endometriosis Classification Systems: An International Survey to Map Current Knowledge and Uptake

Krina T Zondervan, Stacey Missmer, Stacey A. Missmer, Missmer S, Abrao MS, Mauricio S Abrao, Maurício Simões Abrão, Einarsson JI, Jon I Einarsson, Horne AW, Andrew W Horne, Johnson NP, Neil P Johnson, Neil Johnson, Ted T M Lee, Lee TTM, John Petrozza, John C. Petrozza, Petrozza J, Carla Tomassetti, Nathalie Vermeulen, Grimbizis G, Grigoris Grimbizis, Rudy Leon De Wilde, De Wilde RL, International working group of AAGL, ESGE, ESHRE and WES
Journal of minimally invasive gynecology · 2022 · vol. 29(6) , pp. 716–725.e1 · doi:10.1016/j.jmig.2022.01.014 · PMID:35246388 · W4214683656
review OA: green CC0 ⤵ 9 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This international survey investigated current knowledge and uptake of endometriosis classification systems among healthcare professionals.

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Abstract

ObjectiveIn the field of endometriosis, several classification, staging and reporting systems have been developed, but do clinicians routinely use these classification systems, which system do they use and what are the clinicians' motivations?Data sourcesA cross-sectional study was performed to gather data on the current use of endometriosis classification systems, problems encountered and interest in a new simple surgical descriptive system for endometriosis. Of particular focus were three systems most commonly used: the Revised American Society for Reproductive Medicine (rASRM) classification, the Endometriosis Fertility Index (EFI), and the ENZIAN classification. Data were analysed by SPSS. A survey was designed using the online SurveyMonkey tool consisting of 11 questions concerning three domains-participants background, existing classification systems and intentions with regards to a new classification system for endometriosis. Replies were collected between 15 May and 1 July 2020.Methods of study selectionna TABULATION, INTEGRATION AND RESULTS: The final dataset included the replies of 1178 clinicians, including surgeons, gynecologists, reproductive endocrinologists, fertility specialists and sonographers, all managing women with endometriosis in their clinical practice. Overall, 75.5% of the professionals indicate that they currently use a classification system for endometriosis. The rASRM classification system was the best known and used system, the EFI system and ENZIAN system were known by a majority of the professionals but used by only a minority. The lack of clinical relevance was most often selected as a problem with using any system. The findings of the survey suggest that clinicians worldwide are open to using a new classification system for endometriosis that can achieve standardized reporting, and is clinically relevant and simple. The findings therefore support future initiatives for the development of a new descriptive system for endometriosis and provide information on user expectations and conditions for universal uptake of such a system.ConclusionEven with a high uptake of the existing endometriosis classification systems (rASRM, ENZIAN and EFI), most clinicians managing endometriosis would like a new simple surgical descriptive system for endometriosis.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Infertility, Female Reproductive Medicine Cross-Sectional Studies Female Fertility Humans

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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