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In addition, from the point of view of immune regulation, obesity-induced OS can enhance M1 macrophage polarization, increase the cytotoxicity of NK cells, increase the expression of pro-inflammatory cytokines and further impair endometrial decidualization by suppressing the population of FOXP3+ regulatory T cells ( Furthermore, decidualization is a process of coordinated changes in cell morphology and function, angiogenesis, extracellular matrix remodeling, and adaptation of the immune microenvironment

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