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The downstream accumulation of oxidative stress mediated by reactive oxygen species (ROS) from mitochondrial damage, activation of apoptotic pathways, and the disruption of enzymatic and non-enzymatic machinery may facilitate premature follicle activation, follicular apoptosis, and oocyte quality deterioration resulting in the loss of the ovarian reserve and POI

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DNA methylation regulates gene expression by recruiting proteins involved in gene repression or by inhibiting the binding of transcription factor(s) to DNA