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Overall, these three forms of cell death interact and transform during DOR progression, collectively driving the loss of follicular granulosa cells and the decline of ovarian reserve

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For instance: decreasing androgen receptor expression

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DES(1-3) IGF-1 is a truncated variant missing the first three N-terminal amino acids (Gly-Pro-Glu), which also reduces IGFBP binding but through a different structural mechanism removal of the N-terminal tripeptide rather than charge substitution