ABSTRACT
The extent of endometriosis is usually staged by the American Fertility Society (AFS) classification system. The high scores achieved in the presence of adhesions mean that endometriosis is classified as moderate or severe, even though the active disease process may have been eliminated and only the adhesions persist. The existing classification correlates well with the chance of spontaneous conception. Women with minimal–mild endometriosis have near normal conception rates, while women with moderate and severe disease have reduced conception rates. Currently, endometriosis is diagnosed from both its typical and its atypical laparoscopic appearances and histological features. The diagnosis of endometriosis requires visual assessment of the pelvis by laparotomy or laparoscopy. Laparoscopy is associated with significant morbidity, and it has a number of inherent faults. The diagnostic accuracy of laparoscopy relies upon the operator’s visual and subjective assessment of the pelvis. Laparoscopy is associated with significant morbidity, and it has a number of inherent faults.
