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It is suggested that it may be caused by immune disorders, hormonal imbalances, genetic predisposition, obesity, smoking, and environmental factors, including diet (216)

doi: 10.3390/jfmk6040093

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As with any dietary supplement, discontinue use and consult your healthcare professional if unexpected side effects occur.

High homocysteine levels are associated with reduced fertility in many ways including, poor oocyte quality, miscarriage, hypertension, and low birth weight

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