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While these products are often marketed as "wellness" breakthroughs, many have not been assessed for safety, efficacy, or quality, posing severe risks such as hormonal imbalances, liver damage, and infections

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Practical takeaway Until stronger evidence exists, the review argues the path forward is collaborative pregnancy registries + better real-world data, so inadvertent exposures can be counselled with confidenceand so we can finally test whether pharmacotherapy could ever play a role in carefully selected high-risk cases