THE EFFICACY OF HYOSCINE BUTYLBROMIDE ADMINISTRATION BEFORE EMBRYO TRANSFER ON EMBRYO TRANSFER DIFFICULTY AND ICSI OUTCOME

Background: The embryo transfer procedure is IVF's final and most crucial step (ET). The implantation rate and overall effectiveness of IVF can be influenced by a number of variables, including embryo quality, endometrial receptivity, and ET method. The use of ultrasound guidance, uterine contractions during ET, and the type of catheter used during the procedure are the three main factors that affect whether the treatment is successful or not. Therefore, it is preferable to prevent the start of uterine contractions when transferring the embryo. Objective: The purpose of this study was to evaluate the effect of giving hyoscine butyl bromide before embryo transfer on the difficulty of embryo transfer and the outcomes 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 hyoscine, while the second received glucose water 5% as a placebo, 30 minutes before embryo transfer . The data was examined using Fisher exact tests, χ2, t-test, an ANOVA, by SPSS version 22.0. Results: Pregnancy rates were 41.25% overall. Easy ET was significantly greater than difficult ET in the hyoscine group (56.7% versus 30%) than in the control group (43.3% versus 70%), with a p-value of 0.039. Analysis and comparison of the ICSI results between the two groups. Hyoscine significantly outperformed the control group in terms of implantation rate, clinical pregnancy rate, ( IR ; 23 % versus 11% ) p=0.040 , ( CPR; 52.5 % versus 30 %)p=0.041 respectively and non- significant higher live birth rates ( LBRs ; 81 % versus 50% )p=0.114 , there was also no significant difference between hyoscine and control group in miscarriage rate with the lowest rate in hyoscine group (19 % versus 50%) and p= 0.114. Conclusion: By lowering uterine contraction and cervical muscular spasm, it appears that hyoscine butylbromide given 30 minutes before embryo transfer can significantly increase easy embryo transfer, implantation rate and clinical pregnancy rates with a non-significant rise in LBRs, and decrease miscarriage rate.