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Objective: This article presents the KD algorithm developed by a multidisciplinary team of experts at the Children's Hospital, Ain Shams University, Egypt

however, contemporary insights highlight a significant male contribution

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Other oxidative stress triggers include a poor diet, low physical activity, prolonged stress, and intrinsic factors, such as mitochondrial dysfunction leading to reduced adenosine 5-triphosphate (ATP) production, inflammation, and hypoxia (106, 117)

The choline utilization (cut) gene cluster was first identified by Balskus and colleagues, which transforms choline into TMA via gene products of cutC and cutD (Craciun and Balskus, 2012)

Our methodological approaches ensure a rigorous assessment of L-carnitine supplementations impact, yielding valuable insights into its relationship with reproductive outcomes