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According to a recent study (144), the lncRNA HEPFAL acts on SLC7A11 and reduces its expression, resulting in a decrease in the amount of cystine transported into the cell and, as a result, a decrease in the intracellular GSH level, which effectively inhibits the iron apoptosis function of GPX4 and, ultimately, iron apoptosis in tumor cells

Acta Chin Med 2018;33:5214

In vitro oxidation studies in cultured fibroblasts using 13 C- and 14 C-labeled branched chain amino acids indicated an isolated block in 2-methylbutyryl-CoA dehydrogenase (2-MBCDase)

While not primarily a sex hormone issue, endometriosis, age, a history of pelvic inflammatory disease, and fibroids can also contribute to fertility issues