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Article ; Online: Thrombocytes and Platelet-Rich Plasma as Modulators of Reproduction and Fertility.

Nagy, Bernadett / Kovács, Kálmán / Sulyok, Endre / Várnagy, Ákos / Bódis, József

International journal of molecular sciences

2023 Volume 24, Issue 24

Abstract: Thrombocytes play an essential role in hemostasis and thrombosis. Moreover, the controlled activation of thrombocytes is required in reproduction and fertility. The platelet-activating factor and the controlled activation of platelets have important ... ...

Abstract	Thrombocytes play an essential role in hemostasis and thrombosis. Moreover, the controlled activation of thrombocytes is required in reproduction and fertility. The platelet-activating factor and the controlled activation of platelets have important roles in folliculogenesis, ovulation, placental development, implantation and embryo development. Activated platelets accumulate in the follicular vessels surrounding the follicle and, due to its released soluble molecules (factors, mediators, chemokines, cytokines, neurotransmitters), locally increase oocyte maturation and hormone secretion. Furthermore, activated platelets are involved in the pathogenesis of ovarian hyperstimulation syndrome (OHSS) and preeclampsia. Low-dose aspirin can prevent OHSS during ovulation induction, while intrauterine or intraovarian administration of platelet-rich plasma (PRP) increases the endometrium thickness and receptivity as well as oocyte maturation. Activated thrombocytes rapidly release the contents of intracellular granules and have multiple adhesion molecules and receptors on their surface. Considering the numerous homeostatic endocrine functions of thrombocytes, it is reasonable to suppose a platelet-associated regulatory system (PARS) in reproduction. Although we are far from a complete understanding of the regulatory processes, the results of PARS research and the therapeutic application of aspirin and PRP during in vitro fertilization are promising.
MeSH term(s)	Pregnancy ; Female ; Humans ; Blood Platelets ; Placenta ; Fertility ; Fertilization in Vitro/methods ; Embryo Implantation ; Ovarian Hyperstimulation Syndrome ; Platelet-Rich Plasma ; Aspirin/pharmacology
Chemical Substances	Aspirin (R16CO5Y76E)
Language	English
Publishing date	2023-12-11
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms242417336
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Article ; Online: Arthroscopic capsular release is more effective in pain relief than conservative treatment in patients with frozen shoulder.

Skaliczki, Gábor / Kovács, Krisztián / Antal, Imre / Sallai, Imre / Kovács, Beáta / Nyőgér, Zoltán / Géresi, Áron / Kiss, Balázs / Várnagy, Anna

BMC musculoskeletal disorders

2024 Volume 25, Issue 1, Page(s) 145

Abstract: Background: Frozen shoulder is a common medical condition, but the ideal therapeutic method is yet to be determined. Our aim was to analyze the pain-relieving effect of different treatment options used for the management of this disease.: Methods: ... ...

Abstract	Background: Frozen shoulder is a common medical condition, but the ideal therapeutic method is yet to be determined. Our aim was to analyze the pain-relieving effect of different treatment options used for the management of this disease. Methods: Medical records of 59 patients (22 male, 37 female, average age: 55.5 years ±9.9) with early stage primary frozen shoulder were evaluated, their demographic data, physical examination, concomitant diseases and treatment specific data were registered. Life quality and the level of pain were assessed using the Oxford Shoulder Score (OSS) and Numeric Rating Scale (NRS). Different treatment modalities and their effect on pain relief were recorded. Any existing correlation between life quality, pain and demographic data, concomitant diseases or the therapeutic method used was investigated. Results: The level of pain measured on NRS improved from 7.9 ± 1.6 to 1.9 ± 2.2. The most effective therapeutic method in terms of pain relief was surgery, followed by physiotherapy and intraarticular steroid injection (NRS score after treatment: 2 - p < 0.0001; 3.3 - p < 0.0001; 4.9 - p < 0.0001, respectively). Non-steroidal anti-inflammatory drugs (NSAIDs) did not reduce pain significantly. OSS improved from 24 to 43.6 and was not affected by the investigated variables, time to recovery was not influenced by the demographic data, the type of treatment or concomitant diseases. Conclusions: Arthroscopic capsular release, physiotherapy and intraarticular steroid injection outperformed physical therapy and NSAID treatment in terms of pain relief. Despite of slight but persistent post-therapeutic pain found in half of the cases, treatment was considered satisfactory by the patients. Nor patient specific neither therapy specific data had a significant effect on the course of the disease.
MeSH term(s)	Humans ; Male ; Female ; Middle Aged ; Joint Capsule Release ; Arthroscopy/methods ; Conservative Treatment ; Bursitis/surgery ; Pain ; Steroids ; Shoulder Joint/surgery ; Treatment Outcome ; Range of Motion, Articular ; Shoulder Pain/diagnosis ; Shoulder Pain/etiology ; Shoulder Pain/therapy
Chemical Substances	Steroids
Language	English
Publishing date	2024-02-16
Publishing country	England
Document type	Journal Article
ZDB-ID	2041355-5
ISSN	1471-2474 ; 1471-2474
ISSN (online)	1471-2474
ISSN	1471-2474
DOI	10.1186/s12891-024-07275-7
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Article ; Online: Midwife-led integrated pre-birth training and its impact on the fear of childbirth. A qualitative interview study.

Onchonga, David / Várnagy, Ákos / Keraka, Margaret / Wainaina, Pius

Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives

2020 Volume 25, Page(s) 100512

Abstract: Background: Although most expectant women with severe fear of childbirth take pre-birth training sessions, the available literature does not provide substantial emphirical data on its impacts, especially in developing countries like Kenya.: Aim: The ... ...

Abstract	Background: Although most expectant women with severe fear of childbirth take pre-birth training sessions, the available literature does not provide substantial emphirical data on its impacts, especially in developing countries like Kenya. Aim: The study aimed at exploring women's experience from midwife-led integrated pre-birth training and its impact on the fear of childbirth. Method: A qualitative interview was conducted using a thematic analysis. Thirty-three women who had experienced high and severe fear of childbirth, and had completed midwife-led integrated pre-birth training were interviewed one month after giving birth. The interviews were conducted in a maternal and child health clinic in Samburu, Kenya from December 2019 to January 2020. Collected data was analysed based on thematic analysis. Results: The general theme 'midwife-led integrated pre-birth training promoted constructive disposition and enhanced trust in the process of giving birth' was validated by the interviewed participants. Their contributions covered three themes: 'the significance of midwife-led pre-birth training', 'the role of efficient communication during pregnancy,' and 'adaptation to procedures for improved childbirth experience'. Conclusions: In this study 85% (n = 29) of the participants revealed that midwife-led integrated pre-birth training enhanced their expectations for birth processes. They demonstrated readiness and preparedness for this process, which would lead to improved childbirth outcomes.
Language	English
Publishing date	2020-04-12
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2541869-5
ISSN	1877-5764 ; 1877-5756
ISSN (online)	1877-5764
ISSN	1877-5756
DOI	10.1016/j.srhc.2020.100512
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Article ; Online: Does institutional maternity services contribute to the fear of childbirth? A focus group interview study.

Onchonga, David / Keraka, Margaret / MoghaddamHosseini, Vahideh / Várnagy, Ákos

Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives

2021 Volume 30, Page(s) 100669

Abstract: Background: The quality of institutional maternity services offered significantly determine the health outcomes of pregnant women and their infants.: Objectives: The study aimed at understanding perceptions and experiences of new mothers diagnosed ... ...

Abstract	Background: The quality of institutional maternity services offered significantly determine the health outcomes of pregnant women and their infants. Objectives: The study aimed at understanding perceptions and experiences of new mothers diagnosed with the fear of childbirth in Kenya; regarding the institutional maternity services offered and if they contribute to the fear of childbirth (FOC). Methods: This was a qualitative descriptive study. A total of 29 women who had given birth recently in a maternity institution, and had been screened with the fear of childbirth at 32 weeks' gestation period participated in focus group interviews. The Framework for Assessing the Quality of Care of institutional maternity services (FAQC) developed by the University of Southampton was adopted in this study. Thematic analyses were used. Results: It was reported that institutional maternity services contributed directly and indirectly to FOC. The direct contribution included the performance of unintended caesarian sections, severe and prolonged labour pains and negative attitude of healthcare providers. The indirect contribution was in form of challenges in the provision of care and the experience of care in the maternity institutions. In the provision of care; human and physical resources, inadequate referral systems, and inadequate management of emergencies were reported. In the experience of care; lack of cognition, respect, dignity, equity and inadequacies in emotional support were reported. Conclusion: The study identified systemic challenges related to both the provision and the experience of care. Therefore, there is need to astutely analyze all critical steps identified in the FAQC, as this will greatly improve the uptake of institutional maternity services.
MeSH term(s)	Delivery, Obstetric ; Fear ; Female ; Focus Groups ; Humans ; Infant ; Maternal Health Services ; Parturition ; Pregnancy ; Pregnant Women ; Qualitative Research
Language	English
Publishing date	2021-09-21
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2541869-5
ISSN	1877-5764 ; 1877-5756
ISSN (online)	1877-5764
ISSN	1877-5756
DOI	10.1016/j.srhc.2021.100669
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Article ; Online: Translation and validation of the Swahili version of the Wijma Delivery Expectancy/Experience Questionnaire version A (W-DEQ-A).

Onchonga, David / Várnagy, Ákos / Amer, Faten / Viktoria, Prémusz / Wainaina, Pius

Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives

2021 Volume 29, Page(s) 100626

Abstract: Background: Prenatal fear of childbirth is a common health concern that negatively affects the emotional wellbeing of women during pregnancy. Wijma Delivery Expectancy/Experience Questionnaire version A (W-DEQ-A) is used extensively to measure fear of ... ...

Abstract	Background: Prenatal fear of childbirth is a common health concern that negatively affects the emotional wellbeing of women during pregnancy. Wijma Delivery Expectancy/Experience Questionnaire version A (W-DEQ-A) is used extensively to measure fear of childbirth during pregnancy. Nevertheless, previous studies have not evaluated its psychometric characteristics among the Swahili-speaking pregnant women. Therefore, the aim was to translate and test the validity and reliability of the questionnaire into Swahili as the popular language in Kenya. Methods: In the current descriptive cross-sectional study, the W-DEQ-A, together with the Edinburgh Postnatal Depression Scale (EPDS) and Beck Anxiety Inventory (BAI) were administered to a group of 628 pregnant women to explore the dimensionality of W-DEQ-A using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), respectively. Results: EFA and CFA of the Swahili version of W-DEQ-A identified five-factor loadings: lack of self-efficacy, fear, negative emotions, negative appraisal, and social isolation. However, this model failed to support the unidimensional structure of the original W-DEQ-A. The Swahili version of the W-DEQ-A correlated well with EPDS and BAI at acceptable levels. The Cronbach alpha values of the subscales ranged from 0.867 to 0.967, an indication of an excellent internal consistency of the instrument. Conclusion: The current study findings provide support for the Swahili version of the W-DEQ-A to be considered as a valid and reliable measuring tool for the fear of childbirth among Swahili-speaking pregnant women in Kenya, and the entire East and Central African region. Also, due to its multidimensional structure, the original W-DEQ-A should not be used in its original form.
MeSH term(s)	Cross-Sectional Studies ; Female ; Humans ; Language ; Parturition ; Pregnancy ; Reproducibility of Results ; Surveys and Questionnaires
Language	English
Publishing date	2021-04-25
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2541869-5
ISSN	1877-5764 ; 1877-5756
ISSN (online)	1877-5764
ISSN	1877-5756
DOI	10.1016/j.srhc.2021.100626
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Article: Tissue Sodium Accumulation: Pathophysiology and Clinical Implications.

Sulyok, Endre / Farkas, Bálint / Nagy, Bernadett / Várnagy, Ákos / Kovács, Kálmán / Bódis, József

Antioxidants (Basel, Switzerland)

2022 Volume 11, Issue 4

Abstract: Excessive sodium intake has been well established as a risk factor for the development and progression of cardiovascular and renal diseases. Its adverse effects are achieved by renal sodium retention and related volume expansion and by inducing low-grade ...

Abstract	Excessive sodium intake has been well established as a risk factor for the development and progression of cardiovascular and renal diseases. Its adverse effects are achieved by renal sodium retention and related volume expansion and by inducing low-grade inflammation and oxidative stress (OS) in the target tissues. This review presents the recent concept of nonosmotic sodium storage in the skin interstitium, the subsequent dissociation of sodium and volume homeostasis, and the cellular response to the increased tissue sodium concentration. Furthermore, data are shown on the sodium barrier and buffering potential of the endothelial glycocalyx that may protect the functional integrity of the endothelium when it is challenged by an increased sodium load. Finally, examples will be given of the involvement of oxygen free radicals (OFR) in sodium-induced tissue damage, and some clinical entities will be mentioned that are causally associated with sodium/volume retention and OS.
Language	English
Publishing date	2022-04-09
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2704216-9
ISSN	2076-3921
ISSN	2076-3921
DOI	10.3390/antiox11040750
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Article ; Online: Introducing the Hungarian Version of the SCREENIVF Tool into the Clinical Routine Screening of Emotional Maladjustment.

Prémusz, Viktória / Ács, Pongrác / Bódis, József / Várnagy, Ákos / Lászik, Ágnes / Makai, Alexandra

International journal of environmental research and public health

2022 Volume 19, Issue 16

Abstract: Examining possible psychosocial maladjustments should be an integral part of fertility care. For the early detection of vulnerability, the present study aimed to adapt and test the reliability and validity of the Hungarian version of SCREENIVF against ... ...

Abstract	Examining possible psychosocial maladjustments should be an integral part of fertility care. For the early detection of vulnerability, the present study aimed to adapt and test the reliability and validity of the Hungarian version of SCREENIVF against the Fertility Quality of Life Questionnaire (FertiQoL) in a cross-sectional on subfertile women (n = 60, age 34.6 ± 5.2 years, BMI 24.2 ± 4.9 kg/m2) at a university linked fertility clinic in South-Hungary. A confirmatory factor analysis (CFA) was conducted to investigate the construct validity. For the reliability testing, Cronbach alpha values were calculated. Spearman’s rank correlation tested the criterion validity. Discriminant validity was applied using Mann−Whitney U-test and Kruskal−Wallis test. The Edinburgh Framework and COSMIN checklist were applicable for the analysis using SPSS 27.0; significance was set at p < 0.05. The confirmatory factor analysis indicated a good fit; all dimensions were reliable (α ≥ 0.70). Cronbach’s alpha was excellent (0.825−0.904). Strong correlations were found between the total scale (FertiQoL) and anxiety (R = −0.507, p < 0.001), depression (R = 0.554, p < 0.001), and helplessness cognitions (R = −0.747, p < 0.001) and moderate or no correlation with acceptance cognitions (R = 0.317, p = 0.015) and social support (R = 0.230, p = 0.082). The Hungarian version of SCREENIVF proved a valid and reliable tool to measure psychological maladjustment before ART. A longitudinal, randomized, controlled trial involving the partners could further strengthen the results, which is among our long-term plans.
MeSH term(s)	Adult ; Cross-Sectional Studies ; Female ; Humans ; Hungary ; Psychometrics/methods ; Quality of Life ; Reproducibility of Results ; Surveys and Questionnaires
Language	English
Publishing date	2022-08-16
Publishing country	Switzerland
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph191610147
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Article ; Online: A thrombocyták szerepe a reprodukcióban.

Nagy, Bernadett / Sulyok, Endre / Várnagy, Ákos / Barabás, Andrea / Kovács, Kálmán / Bódis, József

Orvosi hetilap

2022 Volume 163, Issue 32, Page(s) 1254–1260

Abstract: It is well known that platelets play a major role in hemostasis and thrombosis. Beyond these classic functions, the controlled activation of platelets is required in reproduction and immune response. In this review, we attempt to summarize the most ... ...

Abstract	It is well known that platelets play a major role in hemostasis and thrombosis. Beyond these classic functions, the controlled activation of platelets is required in reproduction and immune response. In this review, we attempt to summarize the most important roles of thrombocytes in reproduction. The most recent studies of thrombocyte research provide remarkable insights into the physiological and clinical importance of this cellular fragment. We have summarized the key findings we have taken from the relevant literature - including our previous publications - and emphasized their significance. The platelet-activating factor and the controlled activation of platelets have important role in folliculogenesis, ovulation, placental development, implantation and embryo development. Activated platelets are involved in the pathogenesis of ovarian hyperstimulation syndrome (OHSS) and preeclampsia. Low-dose aspirin can prevent OHSS during ovulation induction, while intrauterine infusion of platelet-rich plasma (PRP) increases the endometrium thickness and receptivity. Activated platelets rapidly release the contents of preformed intracellular granules and have multiple adhesion molecules and receptors on their surface. Considering the numerous homeostatic endocrine functions of platelets, it is reasonable to suppose a platelet-associated regulatory system (PARS) in reproduction. Several studies prove the importance of thrombocytes in various essential physiological processes including reproduction. Although we are far from the complete understanding of the regulatory processes, the results of PARS research and the therapeutic application of aspirin and PRP during in vitro fertilisation are promising. Orv Hetil. 2022; 163(32): 1254-1260.
MeSH term(s)	Aspirin ; Blood Platelets ; Female ; Hemostasis ; Humans ; Ovarian Hyperstimulation Syndrome ; Placenta ; Pregnancy ; Thrombosis
Chemical Substances	Aspirin (R16CO5Y76E)
Language	English
Publishing date	2022-08-07
Publishing country	Hungary
Document type	Journal Article ; Review
ZDB-ID	123879-6
ISSN	1788-6120 ; 0030-6002
ISSN (online)	1788-6120
ISSN	0030-6002
DOI	10.1556/650.2022.32530
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Article ; Online: Preeclampsia subtypes: Clinical aspects regarding pathogenesis, signs, and management with special attention to diuretic administration.

Tamás, Péter / Kovács, Kálmán / Várnagy, Ákos / Farkas, Bálint / Alemu Wami, Girma / Bódis, József

European journal of obstetrics, gynecology, and reproductive biology

2022 Volume 274, Page(s) 175–181

Abstract: During normal pregnancy, blood volume increases by nearly two liters. Distinctively, the absence coupled with the extreme extent regarding the volume expansion, are likely accompanied with pathological conditions. Undoubtedly, preeclampsia, defined as ... ...

Abstract	During normal pregnancy, blood volume increases by nearly two liters. Distinctively, the absence coupled with the extreme extent regarding the volume expansion, are likely accompanied with pathological conditions. Undoubtedly, preeclampsia, defined as the appearance of hypertension and organ deficiency, such as proteinuria during the second half of pregnancy, is not a homogenous disease. Clinically speaking, two main types of preeclampsia can be distinguished, in which a marked difference between them is vascular condition, and consequently, the blood volume. The "classic" preeclampsia, as a two-phase disease, described in the first, latent phase, in which, placenta development is diminished. Agents from this malperfused placenta generate a maternal disease, the second phase, in which endothelial damage leads to hypertension and organ damage due to vasoconstriction and thrombotic microangiopathy. In this hypovolemia-associated condition, decreasing platelet count, signs of hemolysis, renal and liver involvement are characteristic findings; proteinuria is marked and increasing. In the terminal phase, visible edema develops due to increasing capillary transparency, augmenting end-organ damages. "Classic" preeclampsia is a severe and quickly progressing condition with placental insufficiency and consequent fetal growth restriction and oligohydramnios. The outcome of this condition often leads to fetal hypoxia, eclampsia or placental abruption. The management is limited to a diligent prolongation of pregnancy to accomplish improved neonatal pulmonary function, careful diminishing high blood pressure, and delivery induction in due time. The other subtype, associated with relaxed vasculature and high cardiac output, is a maternal disease, in which obesity is an important risk factor since predisposes to enhanced water retention, hypertension, and a weakened endothelial dysfunction. Initially, enhanced water retention leads to lowered extremity edema, which oftentimes progresses to a generalized form and hypertension. In several cases, proteinuria appears most likely due to tissue edema. This condition already fully meets preeclampsia criteria. Laboratory alterations, including proteinuria, are modest and platelet count remains within the normal range. Fetal weight is also normal or frequently over average due to enhanced placental blood supply. It is very likely, further water retention leads to venous congestion, a parenchyma stasis, responsible for ascites, eclampsia, or placental abruption. During the management of this hypervolemia-associated preeclampsia, the administration of diuretic furosemide treatment seemingly offers promise.
MeSH term(s)	Abruptio Placentae ; Diuretics/therapeutic use ; Eclampsia ; Female ; Humans ; Hypertension/complications ; Infant, Newborn ; Placenta ; Pre-Eclampsia/diagnosis ; Pregnancy ; Proteinuria/etiology ; Water
Chemical Substances	Diuretics ; Water (059QF0KO0R)
Language	English
Publishing date	2022-05-31
Publishing country	Ireland
Document type	Journal Article ; Review
ZDB-ID	190605-7
ISSN	1872-7654 ; 0301-2115 ; 0028-2243
ISSN (online)	1872-7654
ISSN	0301-2115 ; 0028-2243
DOI	10.1016/j.ejogrb.2022.05.033
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Article ; Online: Follicular Fluid Proteomic Analysis of Women Undergoing Assisted Reproduction Suggests That Apolipoprotein A1 Is a Potential Fertility Marker.

Kurdi, Csilla / Schmidt, János / Horváth-Szalai, Zoltán / Mauchart, Péter / Gödöny, Krisztina / Várnagy, Ákos / Kovács, Gábor L / Kőszegi, Tamás

International journal of molecular sciences

2023 Volume 25, Issue 1

Abstract: Infertility affects millions worldwide, posing a significant global health challenge. The proteomic analysis of follicular fluid provides a comprehensive view of the complex molecular landscape within ovarian follicles, offering valuable information on ... ...

Abstract	Infertility affects millions worldwide, posing a significant global health challenge. The proteomic analysis of follicular fluid provides a comprehensive view of the complex molecular landscape within ovarian follicles, offering valuable information on the factors influencing oocyte development and on the overall reproductive health. The follicular fluid is derived from the plasma and contains various proteins that can have different roles in oocyte health and infertility, and this fluid is a critical microenvironment for the developing oocytes as well. Using the high-performance liquid chromatography-mass spectrometry method, we investigated the protein composition of the follicular fluid, and after classification, we carried out relative quantification of the identified proteins in the pregnant (P) and non-pregnant (NP) groups. Based on the protein-protein interaction analysis, albumin and apolipoprotein A1 (ApoA1) were found to be hub proteins, and the quantitative comparison of the P and NP groups resulted in a significantly lower concentration of ApoA1 and high-density lipoprotein cholesterol in the P group. As both molecules are involved in the cholesterol transport, we also investigated their role in the development of oocytes and in the prediction of fertility.
MeSH term(s)	Female ; Humans ; Pregnancy ; Apolipoprotein A-I ; Cholesterol, HDL ; Fertility ; Follicular Fluid ; Infertility ; Proteomics ; Reproduction
Chemical Substances	Apolipoprotein A-I ; Cholesterol, HDL ; APOA1 protein, human
Language	English
Publishing date	2023-12-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms25010486
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