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Abnormal sperm morphology Diabetic men exhibit significantly higher rates of abnormal sperm morphology, including head deformities and tail structural anomalies [33, 38, 41]

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This can either lead to rapid breakdown and decreased effectiveness, or delayed absorption resulting in increased side effects and toxic blood levels

Genetic component of hidradenitis suppurativa: Genetics plays a big role in hidradenitis suppurativa with heritability estimated to be ~77% based on twin studies.[ref] Studies in fraternal twins show that genetic susceptibility is likely due to carrying multiple susceptibility variants rather than just a single mutation causing HS.[ref] This means that HS is caused by a combination of genetic susceptibility and environmental or lifestyle factors