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To evaluate the application value of serum 25-hydroxyvitamin D [25 (OH)D], anti-Mullerian hormone (AMH) and inhibin B (INHB) in pregnancy outcome of in vitro fertilization-embryo transfer (IVR-ET) in patients with diminished ovarian reserve (DOR). 292 DOR patients who underwent IVR-ET assisted pregnancy in our hospital from August 2019 to October 2021 were selected, according to the pregnancy outcome after assisted pregnancy, they were divided into pregnancy group (n=158) and non-pregnancy group (n=134), the clinical data and the levels of serum 25(OH)D, AMH and INHB in the two groups were compared, the predictive value of serum 25 (OH)D, AMH and INHB in separate and combination detection for pregnancy failure was evaluated by the receiver operating characteristic (ROC) curve. The influencing factors of pregnancy failure were analyzed by single factor analysis and multiple logistic regression. The levels of serum 25 (OH)D, AMH and INHB in pregnant group were significantly higher than those in non-pregnancy group (P<0.05). ROC curve analysis result showed that the area under the curve (AUC) of serum 25(OH)D, AMH, INHB and their combined detection in predicting IVR-ET pregnancy failure in patients with DOR were 0.714 (0.631~0.802), 0.801 (0.731~0.852), 0.634 (0.578~0.741), 0.853 (0.806~0.913) respectively, the AUC of the combined detection in predicting IVR-ET pregnancy failure in patients with DOR was higher than those in the separate detection. Single factor analysis results showed that the number of sinus follicles<5, the number of retrieved eggs<8, follicle stimulating hormone (FSH) / luteinizing hormone (LH)≥ 1.8, serum 25 (OH)≤ 25.05 μg/L, serum AMH≤ 1.08 ng/mL, serum INHB≤ 84.28 pg/ml in the non-pregnancy group were significantly higher than those in pregnancy group (P<0.05). Multiple logistic regression analysis results showed that FSH/LH≥1.8, serum 25(OH)D≤ 25.05 μg/L, serum AMH≤ 1.08 ng/mL, serum INHB≤ 84.28 pg/mL were the risk factors of IVR-ET pregnancy failurein patients with DOR (P<0.05). The low levels of serum 25(OH)D, AMH and INHB are related to IVR-ET pregnancy failure in patients with DOR, and the combined detection of the above index levels has high auxiliary predictive value for IVR-ET pregnancy failure. [ABSTRACT FROM AUTHOR]