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Concurrently, insulin resistance, chronic inflammation, and obesity contribute to ROS overproduction, while the activity of antioxidant enzymes (such as superoxide dismutase and glutathione peroxidase) are significantly reduced ( In PCOS, excessive ROS inflict damage on oocytes and granulosa cells, disrupt the follicular microenvironment, and impair follicular development and ovulation ( e.g ., CYP17) in ovarian theca cells, exacerbating hyperandrogenemia ( e.g ., vitamin C, vitamin E, N-acetylcysteine) may mitigate oxidative damage, improve insulin sensitivity, and restore ovarian function by neutralizing ROS ( 3.2 Autophagy Autophagy is a fundamental cellular process responsible for degrading and recycling damaged organelles and proteins, playing a critical role in maintaining cellular homeostasis

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Vitamin B12 , meanwhile, may enhance mitochondrial energy production , translating to improved mood, focus, and motivation in patients who are fatigued or struggling with weight loss plateaus

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