CAN STAGING SYSTEMS FOR ENDOMETRIOSIS BASED ON ANATOMIC LOCATION AND LESION TYPE PREDICT PREGNANCY RATES

Objective-Development of an endometriosis classification system based on empirically derived stages of the disease, to supplant the Acosta ( 1973), Kistner (1977), and American Fertility Society (1985) classific ations, which are based on arbitrarily defined stages and often fail t o predict pregnancy rates. Design-Retrospective cohort analysis. Setti ng-University infertility clinic. Patients and Methods-Women with endo metriosis and greater-than-or-equal-to 1 year of infertility. Diagnosi s of endometriosis was made by direct visualization, with type of lesi on (implant or adhesion) at multiple sites recorded; total of 202 pati ents. All diagnosed infertility problems were treated based on semen a nalysis, postcoital test, and endometrial biopsy. Pregnancy rates were analyzed by life-table and cluster analyses, and combinations of site and type were also analyzed by Cox's regression model. Results-No ind ividual anatomic site or type significantly affected prognosis, nor wa s any cluster useful for predicting outcome. Conclusion-Anatomic site and type of lesion are insufficient for predicting fertility when used as sole components of a clinical staging system for endometriosis.