Background and objective: Failure to get pregnant can be profoundly disappointing, frustrating and eventually lead to a lot of social, medical, and psychological consequences like depression. This study aimed to evaluate the role of uterine biophysical profile in predicting conception in women with a history of infertility. Methods: A prospective diagnostic accuracy study was conducted in Erbil, Iraqi Kurdistan region, in the Maternity Teaching Hospital from October 2019 to September 2020 on 51 women suffering from primary and secondary infertility. Vaginal ultrasound was performed for all the women at mid-cycle and before embryo transfer. The uterine scoring system for reproduction by Applebaum was calculated, and the total score was obtained. Its role in predicting conception was determined. Results: A cut-off of 15 scores of the uterine scoring system for reproduction gave a sensitivity of 86.7% and a specificity of 100%. Factors found to be associated with high rates of pregnancy were endometrial thickness 10-14 mm (P <0.001), distinct trilaminar layer (P <0.001), abundant blood flow within zone 3 (P <0.001), and uterine artery Doppler PI of <2.19 (P <0.001). The last two parameters gave a pregnancy rate of 100%. Conclusion: Applebaum’s uterine scoring system for reproduction is an easy, simple, noninvasive method for predicting pregnancy in women suffering from primary and secondary infertility. Both uterine artery Doppler PI and endometrial receptivity (including thickness, character, and vascularity) are two important parameters in predicting suitable environment for implantation and pregnancy outcome. Keywords: Uterine scoring system for reproduction (USSR); Uterine biophysical profile; In-vitro fertilization (IVF); Intrauterine insemination.
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