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On the clinico-neurophysiological side, understanding of SMS progressed with the description of abnormal excitotoxicity and paroxysmal autonomic dysfunction [13,14,15], recognition of clinical heterogeneity [4, 7,8,9], and subdividing SMS into stiff trunk (man) syndrome, stiff limb syndrome and progressive encephalomyelitis with rigidity [16]

Additionally, MSCs can inhibit dendritic cell maturation and attenuate the cytotoxicity of NK cells, further contributing to immune tolerance [58, 59]

Not every IVF outcome will change dramatically with lifestyle adjustments, as there are factors beyond our control

The reviewed studies are summarised in Table 1

This approach preempts a post-surgical reduction in oocytes and maintains the high pregnancy and low miscarriage rates of the age of the patient when the embryo was created and frozen, rather than of the more advanced age when the embryo is transferred