TNF and polycystic ovary syndrome: Increased circulating levels of pro-inflammatory mediators, including highly sensitive C-reactive protein (hsCRP), tumour necrosis factor (TNF)-alpha, procalcitonin and interleukin-18 (IL-18), have been reported in women with PCOS (33, 34), and although more pronounced in the context of obesity, these associations persist even after correction for total fat mass.