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The production of IGF-1 is stimulated by growth hormone (GH) and can be retarded by undernutrition, growth hormone insensitivity, lack of growth hormone receptors, or failures of the downstream signaling pathway post GH receptor including SHP2 and STAT5B

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Conversely, granulosa cells show reduced GPx4 expression and ferritinophagy-mediated iron overload, leading to heightened susceptibility to ferroptosis and impaired oocyte quality ( Therapeutic approaches targeting these pathways have been explored

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