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P4 plays a pivotal role in triggering polyploidization and the differentiation of the elongated fibroblastic stromal cells into rounded secreting decidual cells, thereby initiating the secretion of stromal factors such as prolactin (PRL) and insulin-like growth factor binding protein 1 (IGFBP1) to establish an immunotolerant and nutrient-rich environment essential for successful embryo implantation and pregnancy maintenance [4, 5]

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