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An intrinsic dysfunction phenotype implies failure to enter or sustain a receptive state despite apparently appropriate timing, often through immune activation, impaired decidualisation trajectories, or abnormal stromalepithelial crosstalk, and therefore warrants etiologic investigation and targeted management rather than calendar-based adjustment [291, 297, 299]

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If you are experiencing excessive appetite suppression, difficulty eating adequate amounts, or unintended weight loss, your provider may need to adjust dosing or timing of medications