The Effect of Magnesium Sulfate Infusion in Women Undergoing Intracytoplasmic Sperm Injection with Respect to Endometrial Thickness and Endometrial Blood Flow

Abstract Background: Magnesium sulfate administration to women undergoing intracytoplasmic sperm injection (ICSI) can significantly increase endometrial receptivity and sub-endometrial vascularity. Objectives: To investigate the effect of magnesium sulfate in subfertile women undergoing ICSI cycles to shed more light on its impact on vascular parameters of endometrium as well as its thickness. Materials and Methods: This randomized controlled clinical trial enrolled 100 subfertile women with an age range of 20 to 39 years. Those women were all subjected to gonadotropin hormone-releasing hormone antagonist protocol and stimulation by recombinant follicle-stimulating hormone (rFSH) at Al-Nahrain Fertility Center, Baghdad, Iraq. On the day of endometrial thickness (ET), the enrolled women were randomly allocated into either an interventional group ( n = 50) or a reference group ( n = 50). The intervention was 4 g infusion of magnesium sulfate over 20 min (magnesium sulfate ampoule 50% 2.5 g in 5 mL, Pioneer, Sulaymaniyah, Iraq), whereas the reference group received glucose water 5% 200 mL (glucose 5% [W/V] 500 mL, B. Braun, Germany). Results: Comparison of mean ET, mean resistive index (RI), mean pulsatility index (PI), and pregnancy rate between the magnesium group and the control group revealed that the mean ET was significantly higher, the mean pulsatility and resistive indices were significantly lower in an interventional group compared to the study group ( P < 0.05). In addition, there was a significant improvement in the pregnancy rate ( P = 0.047). Conclusion: The use of magnesium sulfate infusion is associated with improved pregnancy outcomes, ET, and endometrial blood flow in women undergoing ICSI.