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Many of the previous studies had methodological limitations such as selection bias [10, 12], and limited generalizability [11, 29]

A thorough history can help ascertain whether a woman is likely to be ovulating regularly and identify possible contributors to reduced fertility such as genetics, stress, sexually transmitted infections, vaginal dysbiosis, endometriosis, smoking, high alcohol or caffeine intake, and other lifestyle factors

The high concentration of progesterone is harmful for endometrial receptivity and decidualization