PLOD1 and polycystic ovary syndrome: This phenomenon may be attributed to patients with PCOS usually having better ovarian reserves and higher basic serum LH levels, which are more likely to induce multiple follicle maturation, resulting in a rapid increase in E2 levels in vivo and stimulation of the positive feedback LH peak.[35] The premature appearance of the LH peak leads to follicular premature ovulation or follicular luteinisation.