Background: Assessment of the severity of endometriosis has been inadequate and unsatisfactory. Despite being the standard classification for decades, the rASRM classification still has many drawbacks limiting its practical use.Objective: To evaluate the topography of endometriosis in an attempt to develop a new classification system for endometriosis associated infertility.Design: Pilot Cohort studySetting: University hospital and private practicePatients: 40 infertile patients aged (20-35 years) with laparoscopically diagnosed endometriosis.Intervention: Laparoscopic diagnosis and management followed by non-IVF treatment.Main Outcome(s): Development of a new classification system with the assessment of its descriptive and prognostic potential. Clinical pregnancy achieved for each stage of the rASRM classification and the new classification will be measured. Results: According to rASRM classification (8, 3, 12, 17) cases were stages (I, II, III, IV) of which (75%, 33.3%, 58%, 52.9 %) achieved clinical pregnancy respectively, while according to our new classification (7,4,20, 9) cases were stages (I,II,III,IV), of which (85.7%, 75%, 65%, 11%) achieved clinical pregnancy respectively. Conclusions: Findings from the study of the topography of endometriosis yielded our new classification system; "ADOPT Classification"; a simple practical surgical tool designed for the assessment of endometriosis associated infertility. It respects the pathological evolution of the disease, and might obviate the drawbacks of rASRM classification.