Irregular menstrual periods, hair loss are, acne, excessive hair growth, decreased fertility, and obesity all symptoms of polycystic ovarian syndrome (PCOS), a complicated hormonal disorder. This study, involving 138 women, aimed to explore hormonal and enzyme changes in PCOS patients. The blood sample was obtained from PCOS patients and healthy women to assess cortisol, Vitamin D3 (Vit D3), dopamine, Lactate Dehydrogenase (LDH), zinc, and interleukins IL-15, IL-22, and IL-37 levels. The results revealed significant differences between PCOS and control groups in LDH, cortisol, zinc, Vit D3, and dopamine levels. The study recorded an elevated LDH levels in PCOS when compared to control at P=0.0001, suggesting follicular developmental disorders. Additionally, lower levels of cortisol at P=0.0001, zinc at P=0.0001, Vit D3 at P=0.0001, and dopamine at P=0.0001 were observed in PCOS, indicating potential indicators for the condition. Notably, no significant correlation between cortisol and PCOS was found. Furthermore, the investigation delved into the immunological aspect, studying IL-15, IL-22, and IL-37. PCOS patients exhibited higher levels of IL-15 at p≤0.0001, IL -22 at p≤0.0001 and lower levels of IL-37 at p≤0.0001 as against the control gss age, BMI, and waist circumference. However, no significant correlations were found between IL-37 and clinical features of PCOS, indicating independence from these factors. Correlation analyses revealed relationships between interleukins and LDH, cortisol, zinc, dopamine, and each other. The study extended its focus to molecular aspect, exploring caspase 9 gene expression. Results showed no significant differences between PCOS and control groups. There were fold frequency differences. Notably, the fold mean of irregular menstrual cycle subgroups was significantly higher. Parameters like waist index and history of abortion showed significant associations with caspase 9 gene expression. Nevertheless, attempts to establish a diagnostic "cut-off value" for caspase 9 gene expression did not yield significant results. In conclusion, PCOS patients had higher serum LDH levels than controls, while cortisol, dopamine, zinc, and Vit D3 recorded a significant decrease in patients compared to control, the current result showed a significant impact of the immunological markers the pro-inflammatory cytokines (IL-15, and IL-22) which can be used as a new diagnostic method for PCOS. In addition to the apoptotic caspase-9. Which recorded a significant impact in aborted patients with PCOS. So, according to this result, we may conclude that modulated immune response may impact these patients' pathophysiological state and may consider a promising potential therapeutic marker. Also the study provider valuable insights into the multifaceted aspects of PCOS among Iraqi women.