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Lay Summary Progesterone is an important hormone, which together with estrogen prepares the women endometrium and breast tissue for pregnancy

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Importantly, a substantial number of patients had multiple reasons noted for stopping (21%), underscoring the complexity of real-world medication use and the challenges patients face when using these therapies

Therefore, the balance of sphingolipid metabolism, particularly S1P/Cer ratio, is essential for follicular development and ovulation