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Comment: A commenter stated that when the measure underwent CBE review for the hospital outpatient setting the committee found that the measure did not meet requirements for scientific acceptability, specifically that the sample was too small to report reliability by decile and that the results for validity testing were non-significant

Clinicians should not accelerate dose increases unless patients are tolerating the current dose well

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Results: Evidence indicates local estrogen dominance with progesterone resistance, pervasive immune dysregulation, and oxidative stress with iron-driven ferroptosis that particularly injures granulosa cells, alongside disease-relevant genetic/epigenetic regulators and reproductive-tract/gut microbiome dysbiosis

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