"Studying endometriosis is like nailing Jello to a tree."
Donna Vogel, National Institute of Health 2000
Endometriosis Links and PDFs

Laparoscopic Appearance of Endometriosis
Color Atlas 1991 revised 2007 & 2017

Theories and Concepts
There are more than 80 theories and concerns in the PDF.  
It generally takes seven theories or concepts to discuss
what I have seen and several more to introduce what I
have read
and published.

Endometriosis Fertility Index
The EFI is the only validated staging system for

Stage V for endometriosis was suggested by Michel Canis
and is like the
4B sub-score in the Endometriosis Fertility
by David Adamson.


The microscopic characteristics of endometriosis were
described more than 150 years ago by Rokitansky in 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 (1917) published the first classification of

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 (1969) published an age dependent appearance of
endometriosis starting with an initial water blister

Goldstein (1980) found endometriosis in 47% of
adolescents with chronic pain using a close-up view.  There
were only petechial-like lesions and blebs in 20% of those

Semm (1987) noted subtle clear lesions detected using
meticulous search with magnification and discussed invisible
lesions noted only after coagulation.
Daniel Clyde Martin, M.D., Richmond,
Virginia, Memphis, Tennessee,
, stage 5, what is stage 5