Research, Development and Innovation (R&D&I) Unit

It is an enigmatic disease that represents a serious health problem and affects more than 200 million women worldwide. Its cause is still unknown, and we lack a well-defined therapeutic strategy. It is characterized primarily by debilitating chronic abdominal and pelvic pain, infertility, and dyspareunia, but it can be associated with numerous pathological conditions since it behaves like a low-grade tumor with the capacity to affect any organ. At Inebir, we are researching the development of new strategies for the treatment of endometriosis and the search for new biological markers that will allow for the early diagnosis of this disease and predict its progression.

Over the past thirty years, intensive research has been conducted on this disease, and we now possess a vast amount of knowledge about the molecular pathways that influence cancer development and progression. However, the most recent studies highlight the need to carefully consider the microenvironment surrounding the disease, as external factors may have a direct impact on the growth and progression of tumor cells. Inebir is developing research lines based on the concept of cancer as a holistic disease, encompassing emotional state, immunity, and other general factors within the body that can influence its development and progression.

Data mining techniques offer an important alternative to traditional statistical methods for knowledge generation. Most analyses performed on clinical databases are static, reflecting a situation at a specific point in time, and generally do not allow for the development of more powerful models that provide more comprehensive and accurate information. There is a growing need to study data from a dynamic perspective, enabling knowledge to be updated as new data is added. This should allow us to establish powerful trends or predictive models based on the behavioral patterns revealed by the data itself.

Although these techniques have been applied in other fields and countries, in Spain and within the healthcare sector, experience with them in the field of assisted reproduction is very limited. Inebir has begun a collaboration with the University of Seville to try to gain knowledge of the data from its assisted reproduction treatments. The main objective is the early identification of hormonal responses in patients undergoing in-vitro fertilization (IVF). In vitro By applying predictive data mining to the analysis of information from our clinic, we aim to determine the extent to which these techniques can be applied in this setting. Through this study, we intend to identify behavioral patterns that will allow us to establish a set of rules for continuous improvement protocols. All this analysis is performed using anonymously processed data, guaranteeing the privacy of our patients.

Social and economic changes have contributed to a growing trend of women delaying their first pregnancy and childbirth, thus exposing them to a greater risk of developing diseases that require potentially gonadotoxic treatments before fulfilling their reproductive desires. Furthermore, while most cancer patients are in their fifties or sixties or older, a growing number of girls and young women are also affected and manage to overcome the disease by undergoing treatments that will severely impact their reproductive potential. Preserving reproductive capacity becomes a crucial aspect of these patients' long-term quality of life. In recent years, assisted reproductive technologies have developed new cryopreservation techniques for gametes, embryos, ovarian tissue, and testicular tissue, opening the door to innovative preventative strategies that were unimaginable not long ago. Inebir continues its research in this area to ensure our patients can fulfill their dream of becoming mothers in the future.

No other species exhibits such high rates of embryonic failure due to chromosomal abnormalities as humans. Maternal age is the primary cause associated with numerical aberrations in oocytes, trisomies in embryos and newborns, and implantation failures. Oocyte longevity and meiotic discontinuity are contributing factors. The following data serve as evidence: 7% of oocytes from women under 30 years of age, 21% from women aged 30-39, and more than 66% of oocytes from women over 40 have alterations in chromosome alignment on the spindle. It has been shown that most chromosomal nondisjunctions occur during anaphase I, and only certain abnormal configurations occur later during meiosis II during chromatid separation. The aneuploidy rate of oocytes after meiosis I is 8.6%, and 15% of these are able to complete the second division, values ​​much higher than those shown by sperm (1% and 4%, respectively). Around 90% of trisomies 13, 15, 18, and 21 result from meiotic errors in oogenesis, while the paternal contribution is much smaller. Current knowledge of cell dynamics allows for an explanation of these data from a three-pronged approach: chromosomal, cellular kinetic, and oxidative alterations. Studying the pathophysiological mechanisms of ovarian aging will allow us to develop ovarian rejuvenation strategies.

Groundbreaking studies on the microbes that live within our bodies (microbiota) demonstrate that when protective microorganisms are replaced by pathogenic microorganisms (a phenomenon known as dysbiosis), chronic inflammation is observed, which could be involved in the development of multiple diseases such as neurological disorders, psoriasis, arthritis, and even colon cancer. Furthermore, it has been suggested that dysbiosis could also cause endometriosis and infertility, since the latter is dependent on the presence of estrogen, and it appears that the microbiome influences estrogen levels. Estrogen, in turn, can alter the gut microbiota, so dysbiosis could abnormally increase estrogen levels locally and systemically, creating an optimal immunological and inflammatory environment for the development of endometriotic implants, chronic endometritis, and embryo implantation disorders.