The effect of administrating indomethacin or hyoscine before embryo transfer on ART outcome (a pilot study)

In spite of the great progress in assisted reproductive techniques (ART), and although good quality embryos are transferred, pregnancy rates have remained around 30%-35% due to low implantation rates.

The aim of this study was to assess and compare the effects of administrating indomethacin or hyoscine suppositories prior to embryo transfer on the pregnancy rate in ART cycles.

This double-blind clinical trial was performed in Vali-e-Asr Hospital as a pilot study from August 2005 through December 2006 on 66 infertile women in ART cycles. Controlled ovarian hyperstimulation was done using recombinant FSH (Gonal-F) with a long GnRH analogue protocol. After obtaining written consent, the subjects were randomly allocated into three equal groups (n=22). Groups A and B received indomethacin and hyoscine rectal suppositories, respectively 30 minutes before embryo transfer and group C was the control group. Data were analyzed by χ2, t-test, ANOVA, and Kruskall Wallis tests.

Overall pregnancy rate was 31% (n=21) with 13.6% (n=3) in group A, 45.5% (n=10), and 36% (n=8) in groups B and C respectively, which shows that pregnancy rate is significantly higher in the group using hyoscine compared to the other two groups (p=0.04). Uterine muscle cramps were experienced by 3 women (13.6%) in group C while none were reported by women in groups A or B, which shows a significant difference (p<0.04).

It seems that compared to indomethacin, hyoscine administration 30 minutes prior to embryo transfer can significantly increase pregnancy rates by reducing uterine and cervical muscle spasm.