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Although Wnt-mediated immune evasion has been associated with distinct immune checkpoint and markers of exhaustion expression (including PD-L1, CTLA-4, LAG3, CD86, ICOS, ICOSLG and TNFSF9) (184, 185), a high density of CD163+ myeloid cells and anti-PD1 treatment resistance has observed in overactivated Wnt-PARP signaling (186)

Melatonin supplementation has been shown to enhance the meiotic maturation and developmental competence of these oocytes, thereby improving their potential for successful fertilization and embryo development (85)