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This designation can be challenging for payers to manage, since approval is based on a surrogate endpoint thought to predict clinical benefit

Cardiovasc Ultrasound (2019) 17(1):26

Total sperm motility was significantly correlated to the seminal trace elements and different forms of GSH

Some patients may benefit from slower dose escalation or temporary dose reduction of their GLP-1 medication if constipation becomes problematic, though this should only occur under medical supervision