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For the male partner, this would include 1,2 : Previous fertility and other reproductive issues Sexual activity, libido, and function Past and present medical conditions and medication usage Childhood conditions affecting the reproductive system, such as undescended testicle(s), mumps orchitis, and early puberty Physical or surgical trauma affecting the reproductive tract Alcohol, cigarette, and recreational drug use Occupation and other potential sources of environmental toxin exposure Family history of infertility or other medical conditions Physical examination A screening physical exam can be helpful in identifying lesions, cysts, tumors, varicoceles, and structural abnormalities related to the penis, vas deferens, epididymis, and testicles that may require further assessment

13 (Suppl 1), 118125 (2011)

Medications: Some medications may either inhibit the absorption or metabolize some of the B vitamins

Critical role of hypoxia sensor--HIF-1 in VEGF gene activation

That structure is what makes it work