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Age-related declines in sex hormones and activation of myostatin impair muscle regeneration and metabolism, while chronic low-grade inflammation disrupts protein synthesis and accelerates proteolysis via the ubiquitin–proteasome system (UPS) and autophagy–lysosome pathway (ALP)

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After adjustment for potential confounders, multivariate regression analysis showed that women with average vitamin B12 levels (293.31–422.44 pg/mL) had a significantly higher clinical pregnancy rate compared to those with low vitamin B12 (adjusted OR = 1.83, 95% CI: 1.03–3.25