TNF and spindle cell hemangioma: In PCOS, interleukin-1β and TNF-α levels, positively correlated with some insulin resistance indicators and TNF-α with AMH, were also significantly elevated in both SCH and TAI.<h4>Conclusions</h4>SCH and TAI independently and synergistically promoted chronic inflammation in normogonadotropic anovulation, particularly in PCOS, through elevated TNF-α and disrupted interleukin-1β/IL-10 balance, with significant implications for metabolic health and ovarian function.