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In granulosa cells of women with endometriosis, elevated lipid peroxidation markers such as malondialdehyde (MDA) and 4-hydroxynonenal (4-HNE) have been observed, accompanied by decreased glutathione (GSH) and glutathione peroxidase 4 (GPx4), key inhibitors of ferroptosis ( Ferroptosis exerts a double-edged effect in endometriosis: while it damages ovarian granulosa cells, oocytes, and embryosdisrupting oocyte maturation, decreasing oocyte retrieval rates, and impairing embryonic developmentit also promotes ectopic lesion growth through downstream signaling pathways that enhance angiogenesis and inflammation ( Therapeutically, ferroptosis inducers can promote lipid ROS accumulation and endometriotic cell death but may exacerbate granulosa cell damage, while ferroptosis inhibitors protect granulosa cells against oxidative damage

Cornier M-A, Dabelea D, Hernandez TL, Lindstrom RC, Steig AJ, Stob NR, Van Pelt RE, Wang H, Eckel RH

Vitamin B12 deficiency and the nervous system: beyond metabolic decompensation-comparing biological models and gaining new insights into molecular and cellular mechanisms

That research does not equal approval for injection