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Combined, these effects disrupt normal cyclic hormone patterns, change feedback to the hypothalamus and pituitary, and can result in irregular cycles, low sperm quality, or anovulation

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For example, they induce the demethylation of endogenous retroviral elements (ERVs), activating a viral mimicry state: the double-stranded RNA produced by ERV transcription is recognized by intracellular pattern recognition receptors, leading to enhanced tumor immunogenicity through activation of the MAVS pathway and increased type I interferon production [23, 230]