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A 2015 systematic review and meta-analysis of 8 randomised trials found that NAC produced higher pregnancy rates than placebo across the placebo-comparison subgroup (pregnancy odds ratio 3.97, 95% CI 2.077.59), though in the same analysis NAC was less effective than metformin for pregnancy outcomes (OR 0.40, 95% CI 0.230.71)

May not be tolerable enough for widespread use

These can include headache, mild gastrointestinal discomfort such as nausea, difficulty sleeping, increased bruising tendency, and changes in mood

Someone comparing a 50mg vial protocol against a 100mg vial protocol is really comparing two package sizes of the same research material, not two tiers of proven efficacy