Abnormal Follicle Development
Primary cause of Infertility in PCOS women. This defect is at the level of ovary where multiple follicles are formed in absence of single dominant follicle. Testosterone high in follicular fluid inhibits follicle maturation & lowers fertilisation.
Increased number of fat cells leads to raised leptin and insulin, Luteinizing hormone(LH) and decreased follicle stimulating hormone(FSH) and this disturbance in endocrine milieu leads to anovulation. Insulin affect the competence of oocyte development.
Raised Anti-Mullerian Hormone
High AMH present in women with PCOS plays an integral role in causing anovulation; by inhibiting FSH, hormone which normally promotes follicle development from the small antral stage to ovulation.