Interconnected cell death pathways: central mechanisms and therapeutic targets in impaired follicular development of polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism and insulin resistance, which synergistically disrupt the ovarian microenvironment. This pathological interplay induces chronic inflammation, oxidative stress, and metabolic dysregulation, subsequently triggering aberrant activation of multiple forms of programmed cell death (PCD) in granulosa cells, including apoptosis, pyroptosis, necroptosis, autophagy, and ferroptosis. Recent experimental studies, mainly based on animal an