Prediction of pregnancy rate of in vitro fertilization and embryo transferin women aged 40 and over with basal uterine artery pulsatility index

Purpose: The purpose was to determine the effect of basal uterine perfusion on the pregnancy rates of in vitro fertilization and embryo transfer (IVF- ET) in women aged 40 and above. Methods: A total of 47 patient aged 40 and over underwent IVF-ET The concep tion cycles and the nonconception cycles were compared. Results: Of the 47 patients, 4 patients were pregnant (8.5%). The mean age, basal follicle stimulating hormone (FSH), basal estradiol (E-2) level, ant ral follicle count (AFC), number of ampoules of gonadotropin used, E-2 leve ls and endometrial thickness on the day of human chorionic gonadotropin (hC G) administration, number of retrieved and fertilized oocytes, and number o f transferred embryos were not statistically significant between the concep tion and nonconception cycles. However the basal uterine artery pulsatility index (UA PI) was significantly lower in the conception cycles (P < 0.001) . The receiver operating characteristics (ROC) curve analysis for basal FSH , AFC, and basal UA PI in predicting the pregnancy rate of IVF in patients aged <greater than or equal to> 40 were demonstrated The best prediction ra te was achieved by a pulsatility index cutoff of < 2.0 for a receptive uter us. Conclusions: Increased uterine perfusion in the early follicular phase enha nced the pregnancy rare of IVF in women aged 40 and above. It is therefore essential that patients aged <greater than or equal to> 40 with poor basal uterine perfusion should be identified early in the early follicular phase of the menstrual cycle to apply appropriate intervention to improve the ute rine circulation for the subsequent chance of pregnancy.