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But chronic psychological stress does elevate cortisol levels, which can impair ovarian blood flow, disrupt hormonal signalling, and increase systemic oxidative stress, all of which may affect the follicular environment. While acute stress is unlikely to damage egg quality, prolonged or severe stress may compound the effects of other risk factors

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Those with a uterus (n = 16,608) received either combined conjugated equine estrogen (CEE 0.625 mg/day) plus medroxyprogesterone acetate (MPA 2.5 mg/day) or placebo

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