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1 Background: metabolic-reproductive challenges of PCOS across lifespan 1.1 Epidemiology and reproductive impact Polycystic Ovary Syndrome (PCOS) is recognized not only as a reproductive disorder in women of childbearing age but also as a complex, lifelong cardiometabolic risk state ( Due to oligo-ovulation or amenorrhea, PCOS leads to a decline in natural conception rates ( This risk, superimposed with delayed childbearing, amplifies reproductive uncertainty