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In a prospective cohort study involving a clinical population of 1,228 women of childbearing age who were planning to conceive naturally, those who were exposed to SSRIs experienced a 24% reduction in the ability to conceive, with fluoxetine exerting an even more pronounced effect than other SSRIs, as well as a 9% reduction in the incidence of live births

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Its role is complementary and can vary depending on whether a direct or precursor-based approach is preferred