SHBG and Hyperinsulinemia: It is hypothesized that insulin resistance leads to hyperinsulinemia and as a result , increased insulin promotes secretion of androgens from the ovaries, which itself decreases the amount of serum sex hormone binding globulin (SHBG), therefore, serum free testosterone is elevated and ovarian follicle growth and maturation is altered by hyperinsulinemia and androgen excess (3).