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VitB12 also plays a critical role in fertility for both sexes by supporting gamete quality. Despite some contradictions, emerging evidence suggests early\u2010life VitB12 deficiency may affect learning and cognitive development. Collectively, these findings suggest that VitB12 is a key determinant of both reproductive and developmental health. Mechanistically, VitB12 acts as a coenzyme in one\u2010carbon metabolism, and its deficiency leads to elevated homocysteine (Hcy) and methylmalonic acid (MMA) levels, promoting oxidative stress and thereby impairing fertility. Although this remains the most established mechanism, other yet unidentified pathways may also mediate the effects of VitB12 on reproductive function. While the effects of severe VitB12 deficiency are well established, mild deficiencies may develop silently in individuals following plant\u2010based diets or those with gastrointestinal disorders. Plant\u2010based sources of VitB12 remain controversial, as many provide only trace amounts or biologically inactive analogs such as pseudovitamin B12, which may interfere with absorption. Further research is needed to evaluate their bioavailability and clinical effectiveness. This review synthesizes clinical evidence, mechanistic insights, and dietary considerations to highlight how VitB12 status shapes reproductive health.<\/jats:p>","DOI":"10.1002\/mrd.70088","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T12:02:27Z","timestamp":1771502547000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Vitamin B12 and Reproductive Health: Clinical Insights, Emerging Mechanistic Understanding, and Nutritional Aspects"],"prefix":"10.1002","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6546-9377","authenticated-orcid":false,"given":"Aimee Rachel","family":"Mathew","sequence":"first","affiliation":[{"name":"Department of Biology and Biotechnologies \u201cCharles Darwin\u201d University of Rome Sapienza Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1579-6229","authenticated-orcid":false,"given":"Erisa","family":"Selita","sequence":"additional","affiliation":[{"name":"Department of Biology and Biotechnologies \u201cCharles Darwin\u201d University of Rome Sapienza Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9407-4786","authenticated-orcid":false,"given":"Chiara","family":"Regano","sequence":"additional","affiliation":[{"name":"Department of Biology and Biotechnologies \u201cCharles Darwin\u201d University of Rome Sapienza Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0276-5748","authenticated-orcid":false,"given":"Claudia","family":"Bianco","sequence":"additional","affiliation":[{"name":"Department of Science University Roma Tre Rome Italy"},{"name":"Department of Biomedicine and Prevention University of Rome Tor Vergata Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6862-2998","authenticated-orcid":false,"given":"Veronica","family":"Corsetti","sequence":"additional","affiliation":[{"name":"Institute of Translational Pharmacology (IFT) National Research Council (CNR) of Italy Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3082-6359","authenticated-orcid":false,"given":"Virve","family":"Cavallucci","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina e Chirurgia Traslazionale Universit\u00e0 Cattolica del Sacro Cuore Rome Italy"},{"name":"Fondazione Policlinico Universitario A. 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