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The trans-sulphuration pathway involves conversion of homocysteine to cystathione and ultimately to cysteine in two vitamin B6 dependent reactions catalysed by cystathione--synthase and cystathione lyase respectively (Figure 2)

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1 Men are often overlooked in the initial assessment of couples presenting with infertility, despite male factors being the primary aetiology in 20% of cases and contributing to 50% of cases overall