What rASRM score indicates severe endometriosis?

Stage I (minimal): 1-5 points; Stage II (mild): 6-15; Stage III (moderate): 16-40; Stage IV (severe): >40. Stage does not correlate well with pain severity but correlates with fertility prognosis and likelihood of IVF.

Does laparoscopic excision improve fertility?

Laparoscopic excision of minimal-mild endometriosis improves spontaneous pregnancy rates (OR ~1.66, Marcoux trial). For ovarian endometriomas, cystectomy improves IVF response but reduces ovarian reserve (AMH reduction).

What is deep infiltrating endometriosis (DIE)?

DIE penetrates >5 mm below peritoneum, involving rectovaginal septum, uterosacral ligaments, bladder, or bowel. rASRM stage does not capture DIE well; specific DIE scores (ENZIAN, #ENZIAN) are complementary.

rASRM Endometriosis Stage Classification Score

Calculate the revised American Society for Reproductive Medicine (rASRM) endometriosis classification score from laparoscopy findings. Stages I-IV (minimal-severe). Points for peritoneal/ovarian endometriosis size, adhesions, and cul-de-sac obliteration.

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