Leah Hechtman

Endometriosis is a complicated chronic inflammatory condition. When patients are successful at conceiving, some are able to improve their endometriosis whilst others find it worsens and can develop into adenomyosis. Both conditions require a few key etiological considerations for treatment that reflect the sophistication and complexity of the conditions. Endometriosis and adenomyosis are both multifactorial and comprehensive by nature and are often simplified by clinicians which produce poor outcomes and reduced treatment success.

The oocyte is most influenced by a woman’s maternal grandmother’s health and wellbeing than any other variable in her lifetime – known as the trigenerational effect.

In a clinical context when we are presented with a woman diagnosed with oocyte aging or premature ovarian insufficiency (POI) we are given a clinical conundrum that challenges our belief in current literature, ethical framework of practice and an awareness that some patients recover from oopause to resume cycling normally. How is this so and how can we optimise this for all women?

From the initial conception and the role the seminal microbiome has to the microbial status in utero, research is now helping us to understand the intricacies and interconnectedness of everyone involved. As we evolve our understanding, we can learn strategies to optimise microbial balance and thus improve the health of the next generation.