SHBG and anovulation: If anovulation persists orpregnancy does not occur, other medications maybe added to the regime to induce ovulation (5,6) Insulin resistance (hyperinsulinemia) causesthe reduced production of sex hormone bindingglobulin (SHBG) in the liver, the overproductionof ovarian and peripheral androgen, and anincrease in luteinizing hormone levels that manifestas anovulation in PCOS patients (7).