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However, severely distorted pelvic anatomy increases surgical risk, making assisted reproductive technologies (ART) like IVF preferable in such scenarios ( 3.4 Disruption of folliculogenesis and oocyte function by the endometriotic microenvironment The endometriotic microenvironment is characterized by elevated levels of reactive oxygen species (ROS), iron overload, pro-inflammatory cytokines, and altered immune cell infiltration

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This section integrates direct hormonal effects with stress alleviation mechanisms