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These factors collectively contribute to further cellular and tissue damage, as well as apoptosis ( 3.3 Antioxidant interventions for the preservation of ovarian tissue and oocyte in the context of in vitro fertilization Oxidative stress triggers apoptosis in granulosa cells, leading to the upregulation of pro-apoptotic factors and the downregulation of anti-apoptotic proteins, ultimately causing ovarian tissue damage and follicular depletion ( Table 1 (82, 83)

This is particularly true in the pediatric population, but also occurs in adults, especially older adults