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These findings describe associations in a large administrative dataset and do not establish causation

As diabetes progresses, total sperm count and motility continuously decline, with corresponding damage and atrophy of the seminiferous tubules, leading to reduced epithelial cell layers and even complete loss of reproductive function [30]

FDA approval requires formal clinical trials, safety and efficacy review, labeling approval, and manufacturing validation under a New Drug Application (NDA) or Biologics License Application (BLA)

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7B) and the gene set enrichment analysis (GSEA) (Fig