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It has been reported that IGFBP-3 binds to a nuclear receptor, 9-cis retinoic acid receptor-alpha (RXR-), which interacts with peroxisome proliferator activated receptor-gamma (PPAR-), a nuclear protein involved in the regulation of glucose and lipid metabolism [175, 176]

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Possible complications include hemorrhage, uterine perforation, cervical laceration, uterine scars, and infertility (Khan 2014