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s a significant challenge in placebo surgery trials, and individual decisions to participate appear to be sensitive to preferences around treatment. Understanding and quantifying the role patient and clinician preferences may play in surgical trials may contribute to the optimisation of the design and implementation of clinical trials in surgery. Female reproductive tractdysbiosis impacts implantation. However, whether gut dysbiosis influencesimplantation failure and whether it accompanies reproductive tract dysbiosisremains scantly explo