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Confounding Dietary Factors: This is a big one

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Excessive generation of ROS within ovarian, adipose, and hepatic tissues overpowers antioxidant defenses, leading to oxidative damage of lipids, proteins, and mitochondrial DNA ( Androgen excess exacerbates redox disequilibrium by promoting NADPH oxidase activity and mitochondrial ROS production, while simultaneously impairing follicular maturation and oocyte quality ( Figure 1 represents the involvement of redox imbalance and endocrine dysregulation in the ovary, leading to hyperandrogenism or PCOS

Mechanism of Action and the Effect of Beta-Hydroxy-Beta-Methylbutyrate (HMB) Supplementation on Different Types of Physical Performance - A Systematic Review