ABSTRACT
Objective: To explore the surface-enhanced Raman spectroscopy (SERS) difference of key female fertility indicators, estradiol (E2), anti-Müllerian hormone (AMH) and antral follicle count (AFC) in serum samples of healthy and infertile women, and the possibility of their application in preliminary screening of clinical female fertility. Methods: A total of 236 serum samples of healthy and infertile women of childbearing age were collected from Reproductive Medical Center of the First Affliated Hospital with Nanjing Medical University. The ages of all subjects ranged from 22 to 49 years old, with an average age of (30.8 ± 5.1) years old. The samples were divided into high E2 value group (>5 000 pmol/L, 78 cases) and low E2 value group ( 14, 68 cases) and low AFC value group (<7, 34 cases). Serum SERS analysis was established and Raman spectra of each group were detected. Orthogonal partial least squares discriminant analysis (OPLS-DA), receiver operating characteristic (ROC) curve and permutation test were used to analyze the signals. Results: The Raman spectrum morphology of serum samples was similar between high and low E2 value groups, high and low AMH value groups, and high and low AFC value groups, but the spectral peak intensity of the three indicators was different between the high and low value groups. In the OPLS-DA model, there was an obvious clustering trend in E2, AMH and AFC between the high and low value groups, and the areas under ROC curve were 0.996 and 0.996, 0.995 and 0.995, and 1 and 1 in high and low E2 value groups, high and low AMH value groups, and high and low AFC value groups, respectively. Conclusion: SERS has a potential to be used in the primary screening of female fertility. Serum SERS profle as an auxiliary method for early diagnosis of infertility is worthy of further study.