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Given the similarities between POEMS syndrome and plasma cell dyscrasias such as multiple myeloma, it could be postulated that the mechanisms in POEMS syndrome causing vitamin B12 deficiency may be similar

However, severely distorted pelvic anatomy increases surgical risk, making assisted reproductive technologies (ART) like IVF preferable in such scenarios ( 3.4 Disruption of folliculogenesis and oocyte function by the endometriotic microenvironment The endometriotic microenvironment is characterized by elevated levels of reactive oxygen species (ROS), iron overload, pro-inflammatory cytokines, and altered immune cell infiltration

Theres no one-size-fits-all frequency for Vitamin B12 injections

However, only 10% of the oral selegiline dose is bioavailable, leading to the need of high, daily doses causing a long list of adverse effects [191]