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Protocols extending beyond one month require sequential vial reconstitution even if dose count mathematically supports longer duration

Breast tenderness or swelling Mild bloating or abdominal cramping Headache or fatigue Water retention (feeling puffy or swollen) Serious (but rare) side effects: Ovarian Hyperstimulation Syndrome (OHSS): severe abdominal pain, rapid weight gain, nausea, or breathing difficulty Increased chance of multiple pregnancies (twins or more) Blood clots (pain, redness, swelling in limbs) Ovarian torsion (twisting of the ovary, resulting in severe pain) Allergic reactions: rash, itching, swelling, or trouble breathing In boys: early puberty signs, such as a deeper voice and increased body hair

and REDEFINE 11, a phase 3 trial with longer duration and patients with BMI 30 kg/m 2

Additionally, they found that melittin suppresses inflammatory target gene expression and NF-B activation through the JNK pathway (Xing et al., 2024)