In the last, polycysticovarian disease (which is typically associated withcentral obesity, insulin resistance, and hyperinsulinism)and alterations affecting obesity-related hormones (e.g.,leptin, adipokines, ghrelin, and endorphins) can affectoocyte quality, fertilization, embryo development, andimplantation, as well as reducing the fertility rate inwomen with a normal menstrual cycle (4-7). Here, GHRL is linked to obesity due to melanocortin 4 receptor deficiency.