Farnoush Farzi, 1 M.D., Marzieh Mehrafza, 2 M.D., Ali Mirmansouri,1 M.D., Mona Oudi,3B.Sc., Ahmad Hoseeini, 4 Ph.D.
1 Department of Anesthesiology, Guilan University of Medical Sciences, Rasht, Iran. & Mehr Infertility Institute, Rasht, Iran. 2 Department of Gynecology & Obstetrics ,Guilan University of Medical Sciences,Rasht,Iran- Mehr Infertility Institute, Rasht, Iran. 3 Member of Mehr Infertility Institute, Rasht, Iran. 4 Cellular and Molecular Biology Research Center, Shaheed Beheshti University of Medical Sciences. Tehran .Iran & Mehr Infertility Institute, Rasht, Iran.
Abstract Background: Recent studies of uterine contractility in IVF–embryo transfer led us to consider an alternative, and possibly complementary, explanation for the high implantation rates of blastocysts. It has been demonstrated that myometrial contractile activity influences embryo implantation, possibly through mechanical displacement of embryos. Objective: The aim of this study was to examine the effect of nitroglycerine (NTG) treatment for priming the uterus on the pregnancy outcome of ICSI-ET programs. Materials and Methods: This study was a prospective, randomized, double-blinded placebocontrolled clinical trial. One hundred consecutive cycles of ICSI-ET on infertile couples were randomly divided into treatment and control groups. The treatment group (50 cycles) received an oral dose of 0.4 mg of NTG, and the control group (50 cycles) received a placebo, 15 minutes before fresh ET. An informed consent from was obtained form each patients. The main outcomes were implantation rate (IR) and pregnancy rate (PR). Results: The mean age of females in the control group and in the treatment group were 30.1±5.1 and 31±5.5 years respectively. Data showed that the mean duration of infertility was not significantly different between control and treatment groups (6.6±5.8 versus 7.8±5.1 years, respectively). The mean number of oocyte retrieval (metaphase II), 2pn, embryo cleaved, embryo transferred and PR weren't different between two Groups (p>0.05). Overall PR was 36%, it was 38% in treatment group and 34% in control group but there wasn’t statistically significant difference between two groups. (p>0.05) Conclusion: NTG didn't increase PR compared to placebo group. These results suggest that NTG treatment before ET isn't effective in the priming of a uterus.
Keywords: Nitroglycerine(NTG), Embryo transfer(ET), Intracytoplasmic sperm injection (ICSI), Pregnancy rate (PR)