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Comorbidities decrease physiological reserve, increasing the risk of life-threatening conditions

Prophylactic treatment of pregnant patients and patients with chronic hemolytic anemias can prevent folic acid deficiency due to the increased requirement for folate in these conditions

B12 is essential for red blood cell production, neurological function, and cellular energy metabolism

A clinically defensible pathway therefore requires standardizing pre-analytics (cycle type, progesterone route, biopsy timing/site), clarifying the clinical question (timing correction vs endotype diagnosis), and integrating receptivity readouts with complementary layers when disruption is suspected, such as immune profiling and endometrial/uterine fluid proteomics/metabolomics, so that non-receptive is interpreted within a multi-dimensional endometrial endotype framework rather than as a single timing label