TNF and hyperandrogenism: According to recent studies including our reports and based on current data, we give the idea that hyperandrogenism triggers ovarian senescence in PCOS cases through the following mechanisms: (1) pivotal decrease in estradiol levels and high concentrations of androgen leading to accelerated follicular atresia; (2) increased TNF-α activity leading to OS and sustained inflammatory status; (3) overproduction of intraovarian toxic free radicals along with a depletion of TAC.