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Endometriosis - Diagnosis

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Biologic Markers for Endometriosis

Investigators are studying certain chemicals detected in blood tests that may prove to help diagnose endometriosis and so avoid invasive diagnostic procedures in many women. Among the most studied to date are CA-125 and CA19-9, which are both elevated in women severe endometriosis. Higher levels of both chemicals occur in many other diseases, however, including ovarian cancer, so results using this test alone do not provide enough information for a definitive diagnosis of endometriosis.

Staging Endometriosis

During laparoscopy, the surgeon determines the number, size, and location of endometrial implants and adhesions. This information helps rank endometriosis by the extent of the disease and give the likelihood of infertility:

  • Minimal (stage I)
  • Mild (stage II)
  • Moderate (stage III)
  • Severe (stage IV)

A number of experts do not believe these categories are useful, because they often do not relate to the intensity of the pain nor to treatment success rates.

Some experts believe it is more accurate to further categorize endometriosis by the depth of penetration:

  • Superficial Endometriosis. Endometriosis that lies more on the surface is more highly associated with infertility than deep implants.
  • Infiltrative Endometriosis. Implants deeper than 5 to 6 mm; deep implants are believed to be the best indicator of progression and severe symptoms.

Review Date: 06/13/2006
Reviewed By: Harvey Simon, M.D., Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital
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