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Some authors noted that in immunocompetent patients, most biopsies showed psoriasiform and pseudoepitheliomatous epidermal hyperplasia with dermal granulomatous inflammation accompanied by varying amounts of necrosis and neutrophilic infiltration

Due to additive pharmacologic effect, the concomitant use of benzodiazepines or other CNS depressants, such as benzodiazepines and other sedative/hypnotics, anxiolytics, tranquilizers, muscle relaxants, general anesthetics, antipsychotics, gabapentinoids (gabapentin or pregabalin), other opioids, and alcohol, can increase the risk of hypotension, respiratory depression, profound sedation, coma, and death

This pro-inflammatory environment not only directly acts on oocytes but also affects the function of granulosa cells and surrounding support cells, leading to impaired follicular development and ovulation disorders