The revised American Fertility Society classification of endometriosis: reproducibility of scoring. ZOLADEX Endometriosis Study Group

OBJECTIVE: To assess the reproducibility in staging endometriosis using the revised American Fertility Society (AFS) classification of endometriosis. DESIGN: Visual documentation of laparoscopies of 315 women with endometriosis was scored by the investigators and a blinded reviewer. SETTING: Patients from private practice institutional setting. PARTICIPANTS: Patients who participated in a multicenter trial to study the efficacy and safety of a GnRH agonist (GnRH-a). INTERVENTIONS: Laparascopic visual documentation of the extent of endometriosis before and after 6 months of GnRH-a therapy. MAIN OUTCOME MEASURE: The reproducibility of the AFS classification system comparing scoring during laparoscopy and by a blinded reviewer. RESULTS: Good to fair agreement scoring endometriosis between the investigator and the blinded reviewer was noted. CONCLUSIONS: Visual documentation may be used to determine the stage of endometriosis using the revised AFS classification guidelines.