Abstract
Assisted reproductive technology methods i.e., IVF and ICSI were extensively used for treatment of infertility. Although, these methods have many advantages but ART pregnancy rate remains low (30% - 35%). It seems that uterine peristalsis occurred after rhCG administration in turn resulting to impair implantation of the transferred embryos. Therefore this study was conducted to possess of whether hyoscine bromide can effectively alleviate uterine contraction and then have any effect on the reproductive outcome. Healthy women who underwent IVF or ICSI cycles (n = 142) were randomly assigned to one of two groups at the start of the cycle. Group control (n = 71) without applied hyoscine and group experiment (n = 71) applied hyoscine (25 mg). Controlled ovarian hyperstimulation was induced with follicle stimulating hormone (FSH). Sperm preparation and ovarian puncture for in vitro maturation and fertilization (IVF) of oocyte were carried out for 42 hours after rhCG injection. Two weeks after rhCG injection, bhCG pregnancy test to determine pregnancy outcome in both groups was done and the outcome results, along with other information were recorded separately. The pregnancy rate in experimental group was significantly higher than that of control group. when all of the cycles with or without giving 25 mg of hyosine were stratified by the mean total follicles (more/less than 2 follicles) and embryos (more/less than25 kg/m2), the Patients’ age, the quality grade of embryos and infertility duration (more/less than 5 years), the reproductive outcome, in overall, in the subjects with more than 10 oocytes, 5 embryos, more than quality A and B grades of embryos, less than 35 years age and also less than 5 years infertility duration was more pronounced than the other patients. But the other parameter was not affected by the reproductive outcome. Clinical or statistical improvement of the reproductive outcome could be demonstrated in the hyosine treated group especially with increasing the mean total follicles, embryo, quality of embryo in women with low age and infertility duration. However, further well-designed studies are essential to offer a final conclusion.
Highlights
Assisted reproductive techniques (ART) include all the ways in which maturation and fertilization of the follicular oocyte by spermatozoa is done outside the uterine and in vitro [1,2]
The pregnancy rate in experimental group was significantly higher than that of control group. when all of the cycles with or without giving 25 mg of hyosine were stratified by the mean total follicles and embryos, the Patients’ age, the quality grade of embryos and infertility duration, the reproductive outcome, in overall, in the subjects with more than 10 oocytes, 5 embryos, more than quality A and B grades of embryos, less than 35 years age and less than 5 years infertility duration was more pronounced than the other patients
It was suggested that stimulation of the ovaries prior to embryo transfer caused high level of estrogen which subsequently increases the intensity of uterine contractions, l as what was observed during menstruation [5]
Summary
Assisted reproductive techniques (ART) include all the ways in which maturation and fertilization of the follicular oocyte by spermatozoa is done outside the uterine and in vitro [1,2]. IVF and embryo transfer techniques in the late 1970s and the technique of intracytoplasmic sperm injection (ICSI) in 1992 are presented [3]. These techniques are caused increasing the rate of clinical pregnancy, but they are faced with some constraints. One of the most useful drugs that have been proposed to reduce uterine contractions is hyoscine bromide [7,8]. This study examines the effects of hyoscine on pregnancy outcomes and its purpose is to answer the question of whether hyoscine is able to reduce uterine contractions during embryo transfer, due to its antispasmodic effect. In this study, the factors affecting the outcome of ART such as age, quality and number of embryos transferred and endometrial thickness were examined
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