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Multiple studies have shown conflicting results on potential negative impacts on sperm numbers and quality as well as DNA fragmentation

Initial protocols often use weekly injections for 48 weeks, then transition to biweekly or monthly maintenance

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For example, a study of MTHFR polymorphism genotypes in colorectal cancer patients reported that the frequency of methylated Bcl-2 promoter was significantly higher in individuals with CC genotype than that of those with CT and TT genotypes, and a significant difference of C and T alleles distribution were observed between patients with methylated and unmethylated Bcl-2 promoter 35

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