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214 This process is performed in repeated cycles, each of which removes a two-carbon acetyl-coA from the acyl-CoA via four enzymes, the enoyl-CoA hydratase, ketoacyl-CoA thiolase, acyl-CoA dehydrogenase (ACADs) and hydroxyacyl-CoA dehydrogenase (HADH)

Mitochondrial dysfunction has been suggested to contribute to CFS (1518) and symptom severity seems to correlate with the degree of mitochondrial dysfunction (19) [for reviews, see (5962)]

[10] Rare thromboembolic events, such as pulmonary embolism, arterial occlusion, and phlebitis have been reported in the literature in association with clomiphene therapy in women who have not had concurrent ovarian hyperstimulation

Therefore, cost-effectiveness should be interpreted within each countrys healthcare cost structure and willingness-to-pay threshold