SHBG and obesity due to melanocortin 4 receptor deficiency: Obesity, in addition to intra-ovarian hyperandrogenism, caused increased tissue targeting by free blood androgen secondary due to the combined effect of the obtained regarding increased adipose tissue synthesis of androgens and decreased sex hormone-binding globulin (SHBG) circulating levels described by [8].Obese women’s ovaries also show apoptosis in granulosa cells, which could be attributed to increased androgen [4].