Excess androgen production was attributed to increased ovarian stromal volume, which comprises theca cells.9,10 Similarly, Christ et al13 found that polycystic morphology with high antral follicle count correlated with higher testosterone and androstenedione levels and LH–follicle-stimulating hormone ratios, indicating more severe hyperandrogenism and reproductive dysfunction. Here, PLOD1 is linked to hyperandrogenism.