Objective：To investigate the predictive value of clinical features combined with intravoxel incoherent motion diffusion- weighted imaging（IVIM-DWI）parameters for early pregnancy outcomes in patients undergoing frozen-thawed embryo transfer（FET）. Methods：This prospective study enrolled 70 infertile women who underwent FET at the Reproductive Center of the First Affiliated Hospital of Nanjing Medical University between December 2023 and January 2025. All participants underwent standardized pelvic magnetic resonance imaging（MRI）scans on the day of embryo transfer. Clinical and laboratory indicators，as well as conventional MRI features and IVIM-DWI parameters were collected. IVIM-DWI parameters（diffusion coefficient D，pseudodiffusion coefficient D* ，and perfusion fraction f）were extracted using FireVoxel software，with histogram data generated via SPSS. Student’s t-test，Pearson’s chisquare test，or Fisher’s exact test were employed to compare differences in clinical characteristics，MRI features，and IVIM - DWI parameters between the clinical pregnancy group and the non - pregnant group . Receiver operating characteristic（ROC）curves were constructed to quantify diagnostic performance using area under the curve（AUC）measurements，with statistical comparisons performed by DeLong’s test. Multivariate logistic regression was used to analyze the relationship between relevant indicators and clinical pregnancy outcomes. Results：The clinical pregnancy group comprised 42 cases，while the non - pregnanct group had 28 cases. The proportion of high-quality embryos in the clinical pregnancy group was higher than that in the non-pregnanct group［76.2% vs. 46.4%， P=0.011］. The junctional zone D* _mean was significantly higher in the clinical pregnancy group than that in the non - pregnancy group （45.233 ± 7.930 vs. 41.223 ± 6.369，P=0.029）. ROC analysis revealed that embryo quality（high-grade embryos）predicted pregnancy success with an AUC of 0.65（sensitivity 53.6%，specificity 73.2%），while junctional zone D* _mean achieved an AUC of 0.68（sensitivity 73.8%，specificity 67.9%）. The combination of embryo quality and junctional zone D* _mean demonstrated superior predictive efficacy （AUC=0.73，sensitivity 82.1%，specificity 60.0%）. Junction zone D* _mean 43.33×10^-3 mm² /s was identified as an independent risk factor for successful clinical pregnancy（OR=0.2，P=0.003）. Conclusion：IVIM - DWI enables noninvasive assessment of microcirculatory perfusion characteristics of FET patients. Combining embryo quality with junctional zone D* _mean enhances the prediction of clinical pregnancy outcomes.