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The physician’s job is to identify whether the biology points to a testis that needs stimulation, a testis that is failing despite normal signaling, a blocked reproductive tract, or a couple-level situation in which time-sensitive ART should take priority.[1,2,4,7,9] [52] For product safety, the clearest rule is also the simplest: whenever possible, use FDA-approved fertility drugs from licensed pharmacies, not compounded or research peptides