Diagnostic accuracy of sonographic transvaginal ovarian biophysical profile as a predictor of infertility taking transvaginal ultrasound as a gold standard

Abstract

Ovarian biophysical profile refers to assessment of ovaries to produce a successful conception and implantation environment. The ovarian scoring system for reproduction comprises the following parameters, taken in mid-cycle: ovarian volume, follicular size, and ovarian artery Doppler flow Resistive index and pulsatility index. Objective: To determine the diagnostic accuracy of sonographic transvaginal ovarian biophysical profile as a predictor of infertility taking transvaginal ultrasound as gold standard. Material and methods: The study comprised women visiting the department with diagnosed infertility for treatment during the period of two years. A total of 550 cycles were inducted primarily referred for ovarian assessment by ultrasound with patent tubes and normal utero-ovarian morphology. All those women having no conception with normal semen analysis of their husbands. Male factor infertility was also excluded. Baseline transvaginal sonography (TVS) was performed at proliferative phase, of the cycle. Mature follicles were studied by TVS. On an individual basis, the following parameters, that is, follicle size, ovarian volume and ovarian artery Doppler Pulsatility index, Resistive index were studied. Follicle size and ovarian artery Doppler flow were highly significant for a pregnancy. Results: The Ovarian biophysical profile was determined by applying the ovarian scoring system for reproduction (OSSR). In this research we compare infertile females with fertile. Out of 550 patients 243 (44.18%) patients were infertile and 307 (55.82%) were normal were discussed, as for as the primary infertile females were 99 (18.00%) and secondary infertile females were 144 (26.18%) and normal were 307 (55.82%). Out of five hundred and fifty cycles 331 woman had a perfect ovarian biophysical profile score of 10. The mean score of fertile was 9.39 ±1.56 and in infertile female was 7.05±2.55. The p- values <0.001. The sensitivity and specificity of ovarian biophysical profile at cut off value 1is 100% and 0.04%. The sensitivity and specificity of ovarian biophysical profile at cut off value 8 it can be consider to rule out in future with 85.3% and 63.8% respectively. Conclusions: Ovarian scoring system for reproduction (OSSR) can prove to be a simple, diagnostic and authentic score to predict the ovarian environment and thereby helping in the prediction of the outcome in infertility. Six out of the nine parameters were found to be high score to predict a pregnancy all by themselves, but these parameters needed expertise and better instrumentation for evaluation. Of the remaining three parameters, two was same or equal on an individual basis and one was found to be not significant.