GFER and obesity due to melanocortin 4 receptor deficiency: It is important to recognize that the negative impact of obesity on women’s reproductive health extends beyond disruptions in the HPO axis; it is also associated with various pregnancy complications and adverse outcomes (Schon et al., 2024), including higher rates of miscarriage and poorer outcomes in assisted reproductive technologies like in vitro fertilization (IVF) (Klenov and Jungheim, 2014).