"Studying endometriosis is like nailing Jello to a tree."
Donna Vogel, National Institute of Health 2000
Click to download free PDF of:
Laparoscopic Appearance
of Endometriosis Color Atlas
1991 revised 2007 & 2017
There are more than 40 theories and concerns.  It generally
takes 5 theories or concepts to explain what I have seen and 10
or more to explain all I have read.

Stage V endometriosis has been discussed by Canis and
suggested as part of the
Endometriosis Fertility Index by


The microscopic characteristics of endometriosis were described
more than 150 years ago by Rokitansky (1861)

Unrecognized microscopic ovarian endometriosis was recognized
more than 100 years ago by Russell in 1899. He postulated the
embryonic origin of endometriosis as Müllerian remnants.

Lockyer published the first classification of endometriosis in 1917.

Sampson published an extensive series of articles and first used
the name endometriosis from 1921 to 1940. He described
chocolate cysts, blebs, adenomyomatous infiltration in the
rectovaginal septum, adherent surfaces, red raspberries, purple
raspberries, blueberries, deep infiltration, inflammatory reactions,
cancer arising in endometriotic implants and peritoneal pockets.

Sampson originally used earlier theories on embryonic origin,
ovarian epithelial metaplasia, dissemination form ovarian
endometriosis, lymphatic spread, and venous emboli, but
subsequently postulated retrograde menstruation of tissue
fragments as the origin of endometriosis.  His retrograde theories
are included in recent theories including retrograde stem cells and
epigenetic changes.

Colorless, amenorrheic lesions were seen by Fallon in 1950.

Karnaky published an age dependent appearance of endometriosis
starting with an initial water blister presentation in 1969

Semm noted subtle clear lesions detected using meticulous search
with magnification and discussed invisible lesions noted only after
coagulation in 1987.