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Adhami, M., Martin, N

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Importantly, the pathophysiological consequences of elevated NET components in the follicular microenvironment are supported by parallel evidence: multiple studies link increased oxidative stress and inflammatory mediators in follicular fluid to reduced oocyte competence, lower fertilization rates, and poorer embryo quality in women with PCOS, providing a biologically plausible pathway by which NET-derived DNA, histones, and proteases could impair gamete quality and fertilization success [55]