I finally got this game working after encountering most of the common issues that people have brought up in this thread (e.g. spontaneous crashing to desktop [ctd], not being able to save, Windows not having permission to access the executable). I fixed it by uncompressing the game to a different drive, which was also mentioned a few times. However, I had to use my bootable SSD C: drive rather than my storage HDD D: drive, opposite of what had been previously suggested.
And don't forget to whitelist hmaho.exe with your antivirus! If you don't have that executable after uncompressing, then your antivirus probably quarantined it, so go look for that listing. I use Webroot and haven't had any significant issues in that regard. I haven't yet encountered the other common issue where the program is blocked after 7 days due to a firewall concern, so I can't say anything about that.
Lastly, this game itself is top-notch. Wastes very little time getting to exactly the reason why you picked it up and looks to have a lot of said content. Original post is missing the lactation tag, as this game has a LOT of that; so if you're into that, you'll definitely be satisfied. For me personally, it's looking to be a 10/10.