It is yet unclear how the ingestion of HSD or other types of hypercaloric diets lead to ovarian dysfunction, however feasible underlying mechanisms include: hyperinsulinemia culminating in higher production of ovarian androgens in synergy with the luteinizing hormone (10), increased expression of anti-mullerian hormone in granulosa cells (19) and increased production of reactive oxygen species (39). The gene discussed is CHST3; the disease is hyperinsulinism.