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While these tools remain the cornerstone of clinical practice, they are inherently limited in their ability to resolve the mechanistic causes underlying idiopathic infertility ( Figure 1 A key limitation across these markers is their static, descriptive nature, which fails to reflect the dynamic processes that influence sperm maturation and function

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Briefly, the adipose tissue through the production of many factors, such as leptin, free fatty acids (FFA), and cytokines may affect both ovarian and endometrium functions, with a final alteration in oocyte maturation and endometrial epithelium receptivity

Both in vivo and in vitro experiments have proved that simvastatin reduce ATP production in a dose-dependent manner and that insulin secretion requires ATP [20]

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