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Objective: To study the relationship between serum leptin, irisin, sex hormone binding globulin (SHBG) and aquaporin 8 (AQP8) and sex hormone levels and pregnancy outcome in patients with polycystic ovary syndrome (PCOS) infertility undergoing in vitro fertilization-embryo transfer (IVF-ET). A total of 293 patients with PCOS infertility undergoing IVF-ET who were admitted to our Hospital from January 2020 to January 2022 were selected, and the patients were divided into clinical pregnancy failure group (n=118) and clinical pregnancy success group (n=175) according to whether or not the pregnancy was clinically successful. Clinical data of patients were collected, and serum leptin, irisin, SHBG and AQP8 levels were measured. Pearson's correlation coefficient was used to analyze the correlation between serum leptin, irisin, SHBG and AQP8 levels and sex hormone levels in PCOS infertility, multivariate Logistic regression was used to analyze influencing factors of pregnancy outcome in PCOS infertility patients undergoing IVF-ET, and receiver operating characteristic (ROC) curves were used to analyze the value of serum leptin, irisin, SHBG and AQP8 levels alone and in combination to predict clinical pregnancy failure in PCOS infertility patients undergoing IVF-ET. Compared to the clinical pregnancy success group, the clinical pregnancy failure group had lower follicle stimulating hormone (FSH), gonadotropin (Gn) dosage, number of eggs gained, fertilization rate, excellent embryo rate and SHBG levels, and higher luteinizing hormone (LH), LH/FSH, testosterone (T), insulin resistance index (HOMA-IR), leptin, irisin and AQP8 levels. Pearson correlation coefficients showed that serum leptin, irisin and AQP8 were negatively correlated with FSH level, and positively correlated with LH, LH/FSH and T levels in patients with PCOS infertility (all P＜0.05). SHBG was positively correlated with FSH level, and negatively correlated with LH, LH/FSHand T levels (all P＜0.05). Multivariate Logistic regression analysis showed that LH/FSH, T, HOMA-IR, leptin, irisin and AQP8 were independent risk factors for clinical pregnancy failure in patients undergoing IVF-ET for PCOS infertility, and excellent embryo rate and SHBG were independent protective factors (all P＜0.05). The ROC curves showed that the area under the curve (AUC) for serum leptin, irisin, SHBG and AQP8 levels in combination to predict clinical pregnancy failure in PCOS infertility patients undergoing IVF-ET were greater than each indicator alone. Serum leptin, irisin, SHBG and AQP8 levels are associated with FSH, LH, LH/FSH, T levels and clinical pregnancy failure in PCOS infertility patients undergoing IVF-ET, and it is helpful to predict the pregnancy outcome of patients with PCOS infertility. [ABSTRACT FROM AUTHOR]