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When stratified by administration route, the average percentage reductions were: Intramuscular (IM): 48.3% Sublingual: 30.7% Oral: 30.3% These results suggest that IM administration leads the most pronounced homocysteine reduction, however, sublingual and oral routes also demonstrate clinically relevant effects

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Future research initiatives must prioritize technological innovation, cumulative exposure evaluation, mechanistic investigation, and global policy advancement to refine risk mitigation strategies and enhance reproductive health protection for current and future generations