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The Peptide Innovation for Early Diabetes Treatment (PIONEER) programme consisted of eight phase 3, randomized, controlled clinical studies and showed that oral semaglutide reduces glycated haemoglobin (HbA1c) and body weight in patients with T2DM and has potential cardiovascular benefits [35,36,37,38,39,40,41,42]

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23 The proposed mechanisms through which obesity can impact male factor subfertility are summarised in Figure 2

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