TNF and polycystic ovary syndrome: Serum and FFconcentrations of TNF-α are also elevated in PCOS patients (Gaafar et al., 2014).TNF-α is a multifaceted cytokine secreted by macrophages and causes theproliferation of granulosa cells and changes in ovarian function (Gaafar et al., 2014; Prins et al., 2020).