What is the cause of paresthesia (tingling sensation) and numbness in a 31-year-old female with a history of recurrent pregnancy losses secondary to endometriosis, who is currently on birth control and was weaned off hormone therapy (hormone replacement therapy) due to In Vitro Fertilization (IVF)?

Differential Diagnosis for a 31-year-old Female with Recurrent Pregnancy Losses and Neurological Symptoms

Single Most Likely Diagnosis

• Vitamin B12 Deficiency: This condition is a common cause of neurological symptoms such as numbness, tingling, and weakness in the extremities. The patient's history of being weaned off hormone therapy due to IVF and being on birth control may contribute to a potential vitamin B12 deficiency, as certain hormonal therapies can affect vitamin B12 levels.

Other Likely Diagnoses

• Peripheral Neuropathy: This condition can be caused by various factors, including hormonal changes, and can lead to symptoms such as numbness, tingling, and weakness in the extremities.
• Fibromyalgia: Although less directly related to the patient's history of endometriosis and IVF, fibromyalgia is a condition that can cause widespread pain, numbness, and tingling sensations, and is more common in women.
• Hormonal Imbalance: The patient's recent weaning off hormone therapy and history of birth control use may contribute to hormonal imbalances, which can cause a variety of symptoms including neurological ones.

Do Not Miss Diagnoses

• Multiple Sclerosis: Although less likely, multiple sclerosis is a serious condition that can cause numbness, tingling, and weakness in the extremities, and would be catastrophic if missed.
• Diabetic Neuropathy: If the patient has undiagnosed diabetes, diabetic neuropathy could be a cause of her symptoms, and would require immediate attention.
• Thyroid Disorder: Certain thyroid disorders, such as hypothyroidism, can cause neurological symptoms, and would be important to rule out given the patient's history of hormonal therapies.

Rare Diagnoses

• Guillain-Barré Syndrome: A rare autoimmune disorder that can cause rapid onset of muscle weakness and numbness, which would be a rare but serious cause of the patient's symptoms.
• Heavy Metal Poisoning: Exposure to certain heavy metals, such as lead or mercury, can cause neurological symptoms, although this would be an unlikely cause without a clear history of exposure.
• Vasculitis: Certain types of vasculitis, such as giant cell arteritis, can cause neurological symptoms, although these conditions are rare and would typically be accompanied by other systemic symptoms.