The Efficacy of Single Dose Magnesium Sulfate Administration Before Embryo Transfer on Icsi Outcome

Abstract

Background: Assisted reproductive methods have made significant advances in the field of infertility therapies. Despite major advancements in ART, the success rate has not considerably risen. Embryo quality, endometrial receptivity, and using proper embryo transfer procedures are the main factors that impact conception. The lack of uterine contractions during embryo transfer is one of the elements that greatly affect endometrial receptivity, making it a target for pharmacological treatments to increase the effectiveness of IVF/ICSI cycles. Objective: The purpose of this study was to determine whether giving magnesium sulfate before embryo transfer improve the results of ICSI in ART cycles. Materials and Methods: From October 2020 to April 2022, 80 infertile women undergoing ART cycles participated in this prospective, randomized clinical trial at the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies/Al-Nahrain University. Recombinant FSH (Gonal-F) was used in a controlled ovarian hyperstimulation technique. The patients were randomly divided into two equal groups (n=40) after receiving written agreement. The first group got a 4gm infusion of magnesium sulfate, while the second received 200ml of 5% glucose water as a placebo, respectively, 30 min. prior to embryo transfer. The data were examined by using the Fisher Exact, ANOVA, t-test, and χ2 tests in SPSS version 22.0. Results: ICSI results were studied and compared between the two groups, and the overall pregnancy rate was 35%. Magnesium sulfate group had non-significantly higher implantation rate, clinical pregnancy rate, and live birth rates than control group; IR ( 20 % versus 11% with P= 0.106), CPR (40 % versus 30 % with P= 0.348) and LBR (81.3 % versus 50 % with P=0.114) respectively, and also non-significant lower miscarriage rate in magnesium sulfate group (18.8 % versus 50 % with P=0.114). Conclusion: Magnesium sulfate injection 30 minutes before embryo transfer appears to increase implantation rate, clinical pregnancy rate, LBRs, and decrease miscarriage rate by decreasing uterine contractility and cervical spasm although it was not statistically significant.