Detection Of PCOS,EMS And Key Female Fertility Evaluation Indicators By Serum SERS

About 10% to 15% of couples of childbearing age in the world are suffering from infertility.Every ontogeny of human results from the effective combination of gametes(sperm and eggs)and which is further implanted and developed in the uterine cavity.Compared with gamete delivery and fertilization,gametogenesis is obviously the primary concern of infertility diagnosis and treatment.Polycystic ovary syndrome(PCOS)directly affects the ovulation of women,which is the most important ovarian disease leading to infertility.More than 50% of PCOS patients are infertile.In addition,due to endometrial migration ectopic,endometriosis(EMS)can cause dysmenorrhea,menstrual disorders and even infertility in women.The prevalence of EMS in infertile women is as high as 30% to50%.Only these two diseases constitute about 30% of the causes of female infertility,which is indeed harmful to women.Due to the self-limitation of female reproductive cells,the fertility of women at childbearing age is closely related to their age.Therefore,early diagnosis,early detection and early treatment of the aforesaid two diseases are of great significance to maintain women’s reproductive health.The cause of female infertility is complex,which is a comprehensive manifestation of genetic,metabolic,endocrine and environmental consequences.The current clinical testing methods are relatively expensive and time consuming.At first,this project established a new surface-enhanced Raman spectroscopy(SERS)detection method,and then test PCOS and EMS,the two diseases significantly affecting the reproductive health of women of childbearing age,and key female fertility evaluation indicators estradiol(E2),anti-Mullerian hormone(AMH),andantral follicle count(AFC),exploring the possibility of SERS in the early diagnosis of clinical infertility.In this study,six groups serum samples were collected from the clinical reproductive medicine centre of Jiangsu Provincial People’s Hospital,and which was numbered by A to F.A normal group(normal person,n=116),B PCOS group(PCOS patients,n=94),C EMS group(EMS patients,n=146),D high E2 value group(>5 000 pmol/L,n=104)and low E2 value group(<500 pmol/L,n=115),E high AMH value group(≥1.1 ng/m L,n=44)and low AMH value group(<1.1 ng/m L,n=40),F high AFC value group(>14,n=90)and Low AFC value group(<7,n=46),a total of 702.All subjects were at the reproductive age(22～49 years old).There was no statistical difference in the age of each group.Serum SERS analysis was established and optimized,and Raman spectra of each group were detected.75% of the samples in each group were used as the training set for statistical processing such as orthogonal partial least squares discriminant analysis(OPLS-DA),receiver operating characteristic(ROC)curve and permutation test.In order to further verify the prediction ability of the model,the remaining 25% of the samples in each group were used as the test set to calculate the accuracy,sensitivity and specificity of the model.The results showed that the Raman spectrum morphology and peak of serum samples were similar between PCOS,EMS and normal group,high and low E2 value groups,high and low AMH value groups,high and low AFC value groups,but the spectral peak intensities were significantly different(P<0.05).In the OPLS-DA model,there was an obvious clustering trend in PCOS,EMS and normal group,and in E2,AMH and AFC between the high and low value groups,and the areas under ROC curve were 1 and 1,0.998 and 0.998,and 0.996 and 0.996,0.995 and 0.995,1 and 1 in normal and PCOS group,normal and EMS group,high and low E2 value groups,high and low AMH value groups,and high and low AFCvalue groups,respectively.After seven-fold cross-validation,the corresponding sensitivity and specificity were 83.33% and 93.10% for the PCOS group and 86.49% and 93.10% for the EMS group.The overall diagnostic accuracy of the disease group was 87.78%.And the accuracy of the E2,AMH,and AFC group models were 87.27%,90.48%,and 88.23%,respectively.Preliminary study shows that serum SERS combined with OPLS-DA model can distinguish normal people from PCOS and EMS patients,and can effectively analyze the key female fertility evaluation indicators of childbearing age.Serum SERS technology as an auxiliary method of early diagnosis of infertility is worth further study.