There is increasing data that hyperinsulinemia produces the hyperandr
ogenism of polycystic ovary syndr
ome by increasing ovarian
ogen production, particularly testosterone and by decreasing the serum sex hormone binding globulin concentration. The high levels of andr
ogenic hormones interfere with the pituitary ovarian axis, leading to increased LH levels, anovulation, amenorrhea, recurrent pregnancy loss, and infertility.