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Article History

Received: 25 January 2026

Accepted: 13 April 2026

First Online: 24 April 2026

Declarations

:

: This research was performed in accordance with the Declaration of Helsinki and ethical approval was sought and given by the Thai Central Research Ethics Committee (CREC) (COA- CREC020/2020), related university research ethics committees, and all hospital research ethics committees of Chaophraya Abhaibhubejhr Hospital (IRB-BHUBEJHR-149), Chiangrai Prachanukroh Hospital (EC CRH 067/63 Ex), Rajavithi Hospital (No 118/2563), Udon Thani Hospital (UDH REC No 28/2564), Nopparatrajathanee Hospital (No 13/2563), Human Research Protection Unit, Faculty of Medicine Siriraj Hospital, Mahidol University (CREC010/62SCm), Center for Ethics in Human Research, Khon Kaen University (HE631255), and Institute Review Board in Human Research, Khon Kaen Hospital (KEMOU63009). Scientific and technical approval was obtained from the WHO Human Reproduction Program (HRP) Review Panel on Research Projects (RP2), and ethical approval by the WHO Ethical Review Committee (protocol ID, 004571) and the French Research Institute for Sustainable Development. Participants provided informed consent and had the opportunity to ask questions at any point during this process. In-depth interviews were conducted in a private place with no other people present.

: Not applicable.

: The authors declare no competing interests.