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Furthermore, diminished levels of growth factors such as IGF-1 and GDF-9 within the follicular microenvironment may further contribute to poor oocyte competence and suboptimal embryo development ( These disruptions highlight the multifactorial impact of the altered ovarian niche in endometriosis, offering a rationale for targeted antioxidant, anti-inflammatory, or ferroptosis-modulating therapies aimed at restoring follicular health and reproductive potential