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We performed RNA-Seq on endometrial tissues from PCOS-IR and PCOS without IR (PCOS-NIR), thereby identifying 339 common differentially expressed genes (DEGs) using DESeq2 and Limma. Functional enrichment analysis revealed that DESeq2-identified genes primarily participated in cellular signaling, metabolic regulation, and immune-related pathways. Further weighted gene co-expression network analysis (WGCNA) identified gene modules highly correlated with the PCOS-IR phenotype. Integrating multi-step strategies, including random forest analysis and STRING interaction networks, ultimately identified\n                    <jats:italic>FGF17<\/jats:italic>\n                    ,\n                    <jats:italic>AKT3<\/jats:italic>\n                    , and\n                    <jats:italic>IRS4<\/jats:italic>\n                    as key candidate genes. Quantitative real-time PCR (qRT-PCR) confirmed that\n                    <jats:italic>FGF17<\/jats:italic>\n                    mRNA expression was significantly downregulated in the endometrium of the PCOS-IR group. This finding suggests that\n                    <jats:italic>FGF17<\/jats:italic>\n                    may play a pivotal role in PCOS-IR-related endometrial dysfunction, with promise as a therapeutic target to improve reproductive outcomes in patients. These results provide important theoretical support for subsequent mechanistic exploration and clinical intervention.\n                  <\/jats:p>","DOI":"10.1007\/s43032-026-02069-9","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T15:39:01Z","timestamp":1773675541000},"page":"643-656","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Molecular Characteristics of the Endometrium in Polycystic Ovary Syndrome with Insulin Resistance"],"prefix":"10.1007","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9265-6847","authenticated-orcid":false,"given":"Yingying","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3702-7593","authenticated-orcid":false,"given":"Hongqing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7087-9099","authenticated-orcid":false,"given":"Yijie","family":"Hui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1616-0848","authenticated-orcid":false,"given":"Yajuan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4960-8474","authenticated-orcid":false,"given":"Hongying","family":"Shan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"issue":"2","key":"2069_CR1","doi-asserted-by":"publisher","first-page":"G43","DOI":"10.1093\/ejendo\/lvad096","volume":"189","author":"HJ Teede","year":"2023","unstructured":"Teede HJ, Tay CT, Laven JJE, Dokras A, Moran LJ, Piltonen TT, et al. 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All patients signed informed consent forms before participating in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval"}},{"value":"All participants gave informed written consent.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Participate"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}