Although some studies observed decreased COX-2 expression in the endometrium51 and granulosa cells52 of PCOS models, most research supports the overactivation of COX-2 in PCOS patients, especially in ovarian tissue53–55, Which is presumed to be related to hyperandrogenism, increased inflammatory responses, and abnormal follicular development in PCOS patients. This evidence concerns the gene PTGS2 and hyperandrogenism.