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JB received educational grant funding from Bayer

However, based on current research data, metabolic factors cannot be ruled out as potential contributing factors

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Consequently, the symbiotic relationship between oocytes and granulosa cells, governed by metabolic and signaling interactions, renders the follicle highly susceptible to mitochondrial dysfunction, which can precipitate a cascade of pathological alterations, including impaired follicular development, abnormal hormone synthesis, and reduced oocyte quality