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Vitamin B12 testing should only be performed when there is reasonable clinical suspicion of deficiency due to the presence of risk factors (Table 1) or clinical findings suggestive of B12 deficiency (Table 2)

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Since the 1960s, the ketogenic diet has been demonstrated to have significant effects in terms of weight loss ( In vitro study has ever demonstrated that ketone bodies being utilized as an energy source for sperm movement ( Our recent study observed the effects of metformin on metabolic imbalance, antioxidant capacity, apoptosis, and reproductive function in male mice with high-fat and high-cholesterol diet-induced obesity, and demonstrated that it protected against the disrupted testicular histology and semen quality by increasing the testosterone concentration and enhancing anti-oxidative enzymes in the testes ( Methods Headings This study was approved by the Institutional Animal Care and Use Committee of the Taipei Medical University (IACUC