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Temperature fluctuations, freeze-thaw cycles, shaking, and high concentrations all promote aggregation

Bacterial contamination : Without preservatives, bacteria grow in liquid solutions

While unadjusted analyses showed no significant differences among groups stratified by vitamin B12 levels, multivariate regression indicated that women with moderate B12 levels (293.31422.44 pg/mL) had significantly higher odds of clinical pregnancy compared to those with low levels (OR = 1.83, P = 0.041)

High Vitamin B12 Levels: Causes, Symptoms, and How to Manage Them Worried about high vitamin B12