A 28-year-old woman from Delhi presents with oligomenorrhea (cycles every 45–60 days), hirsutism (Ferriman-Gallwey score 10), and difficulty conceiving for 2 years. Transvaginal ultrasound shows bilateral ovaries with the appearance shown in the diagram. The structure marked A in the diagram represents >20 peripherally arranged small follicles (2–9 mm) in a "string of pearls" configuration. Which of the following best explains the pathophysiology of arrested follicle development at this stage in PCOS?

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