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The evaluation often incorporates indirect markers such as improved fertilization rates, successful embryo development, and clinical pregnancy rates as proxies for oocyte quality

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Small amounts of bilirubin can be produced from intravascular hemolysis as well (see image below), but most of the bilirubin in a hemolytic anemia with an intravascular component is due to the concurrently occurring extravascular hemolysis (this is because most of the free hemoglobin, which is liberated into plasma with intravascular hemolysis, ends up being lost in the urine versus being converted to bilirubin in macrophages)