GNRH1 and polycystic ovary syndrome: In PCOS patients the increased LH/FSH ratio relates to a high GnRH excretion, but it is still uncertain if an intrinsic malfunction of the GnRH pulse generator or relatively low levels of progesterone, as a result of anovulatory menstrual cycles, are the underlying cause [Figure 2].[5] High GnRH expression could also be caused by low pituitary progesterone sensitivity, due to low circulating androgens.