Fertility preservation in endometriosis: Review of current evidence and best practices / Preservación de la fertilidad en la endometriosis: revisión de la evidencia actual

In recent decades, the field of female fertility preservation has experienced substantial growth. Reliable techniques such as cryopreservation of oocytes and ovarian tissue have emerged, along with more established methods such as embryo freezing. Among the group of patients who can benefit from these new techniques are patients with endometriosis, a common disease capable of compromising ovarian reserve and fertility prospects. Unfortunately, comprehensive recommendations for fertility preservation in patients with endometriosis are still lacking. This narrative review comprehensively explores fertility preservation in patients with endometriosis, using a range of relevant literature, including available national and international guidelines. Additionally, it explains the weight of several factors that contribute to the decision-making process for fertility preservation, including age, severity of endometriosis, ovarian reserve, and previous or future surgery. This manuscript summarizes available recommendations that provide guidance for this vital but challenging aspect of reproductive medicine. Underlines the need for personalized care for patients with an early diagnosis of endometriosis and initial medical treatment to try to reduce the deterioration of ovarian reserve and emphasizes the importance of research to refine fertility preservation strategies in people with endometriosis.(AU)

En las últimas décadas, el campo de la preservación de la fertilidad femenina ha experimentado un crecimiento sustancial. Han surgido técnicas fiables, como la criopreservación de ovocitos y tejido ovárico, junto con algunas más establecidas como la congelación de embriones. Entre el grupo de pacientes que se pueden beneficiar de estos nuevos métodos, están aquellas con endometriosis, una enfermedad frecuente y capaz de comprometer la reserva ovárica y las perspectivas de fertilidad. Desafortunadamente, todavía faltan recomendaciones integrales para la preservación de esta en pacientes con endometriosis. Esta revisión narrativa explora exhaustivamente la conservación de la fertilidad en pacientes con endometriosis, utilizando una variedad de literatura pertinente, incluidas las pautas nacionales e internacionales disponibles. Además, explica el peso de varios factores que contribuyen al proceso de toma de decisiones para conservar la fertilidad, incluida la edad, la gravedad de la endometriosis, la reserva ovárica y la cirugía previa o futura. Este manuscrito, resume las recomendaciones disponibles que brindan orientación para este aspecto vital pero desafiante de la medicina reproductiva. Subraya la necesidad de una atención personalizada a la paciente con un diagnóstico de endometriosis precoz y un tratamiento inicial médico para intentar disminuir el deterioro de la reserva ovárica y enfatiza la importancia de la investigación para refinar las estrategias de preservación de la fertilidad en las personas que presentan endometriosis.(AU)

The cerebrospinal fluid lactate is decreased in early stages of multiple sclerosis

BACKGROUND: The purpose of this study was to investigate if the concentration of lactate can provide additional information for pathologies that need examination of the cerebrospinal fluid (CSF) in their diagnostic controls or protocols. METHODS: A prospective study carried out in the year 2001 at the University Hospital of Bellvitge (Barcelona), on 92 samples of CSF from patients who needed this examination. The concentration of lactate, glucose, and the cell count was determined. One year later, the diagnosis revealed from the previous analyzed samples were sorted into groups according to the diagnosis. RESULTS: In the group with multiple sclerosis (MS) (n = 30), there was a significant decrease in lactate concentration (1.52 +/- 0.19 mmol/L) compared to the control group (1.89 +/- 0.11 mmol/L) (p < 0.001). The glucose concentration remained within the normal range and the cell count was < 4 cell/microL even in the relapses. CONCLUSIONS: In the early stages of MS, the lactate concentration in CSF is decreased and this could be related to alterations in sensitivity observed in those patients. Further studies are needed to evaluate if this lactate concentration is a prognostic indicator of the disease.