There is increasing data that hyperinsulinemia produces the hyperandrogenism of polycyst
ic ovary syndrome by increasing ovarian
androgen production, particularly testo
sterone and by decreasing the serum sex hormone binding globulin concentration. The high levels of androgenic hormones interfere with the pituitary ovarian axis, leading to
increased LH levels, anovulation, amenorrhea, recurrent pregnancy loss, and infertility.