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These conditions often cause intermittent symptom worsening, reduced physical activity, increased hospitalization risk, and loss of income

While some studies reported adverse effects with reduced clinical pregnancy rates 33,34 , increased abortion rates 33,53 , fewer oocytes per OPU 42,54,55,56 , lower fertilisation rates 54,57 , reduced endometrial thickness 37 , higher gonadotropin dosages for ovarian stimulation 58 , and increased cytoplasmic and meiotic anomalies 55,59 , others did not confirm these findings