Yes. There are three grading systems commonly in use. According to the American Society of Reproductive Medicine guidelines, an individual’s endometriosis can be classified as stages I–IV, as follows: Stage I is minimal, Stage II is mild, Stage III is moderate, Stage IV is severe.[1] Endometriosis can also be graded by the Endometriosis Fertility Index (EFI), which grades endometriosis according to its impact on fertility,[2] or the Enzian classification system, which is designed to describe both the location and severity of endometriosis.[3] The most commonly used system is the American Society of Reproductive Medicine’s, but deeply infiltrating endometriosis (DIE) is better described by the Enzian system, and the EFI is much more useful for predicting endometriosis’s impact on fertility.
Are there different severities of endometriosis?
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•Last Updated: May 16, 2025
Yes, endometriosis can vary in severity and is commonly classified using 3 grading systems: the American Society of Reproductive Medicine's stages I–IV, the Endometriosis Fertility Index (EFI), and the Enzian classification system. The American Society of Reproductive Medicine's system is the most widely used, whereas the Enzian system is better for describing deeply infiltrating endometriosis, and the EFI focuses on fertility effects.