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5 The relationship between EMS-induced GCs abnormalities and oocyte quality Current research indicates that EMS-induced oxidative stress, inflammation, aberrant mitochondrial energy metabolism, inappropriate steroid production, and apoptosis in GCs can all impair the quality of oocytes to variable degrees

V., Gordon, J

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doi: 10.1016/j.freeradbiomed.2018.06.023

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Absorption problems Even with adequate intake, absorption can be reduced by: Certain gastrointestinal conditions affecting the stomach or small intestine Some medications Age-related reduction in stomach acid (which can affect absorption) Autoimmune gastritis (often historically referred to as pernicious anaemia) This is a well-recognised cause of B12 deficiency and may require ongoing management