Potential mechanisms underlying the development of PCOS

Inherited factors act to create a susceptible genotype, most commonly identifiable by a positive family history for PCOS or related features. This susceptible genotype, in isolation or in association with environmental or acquired factors, may result in intermediate forms of functional hyperandrogenism. Continued exposure to environmental factors, or an increasing load of genetic variants favoring its occurrence, leads to the development of clinically evident PCOS.