The effect of selecting oocytes for insemination and transferring all resultant embryos without selection on outcomes of assisted reproduction.

OBJECTIVE: To evaluate the effect of selecting three best oocytes for insemination and transfer of all resultant embryos on outcomes of assisted reproductive technologies (ART). STUDY DESIGN: Comparative study. SETTING: The Center of Reproductive Medicine, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. PATIENT(S): Women undergoing ART during the period March 10, 2004 to March 9, 2006. INTERVENTION(S): Comparing outcomes of ART following transfers of 3 "excellent" (n = 267) embryos and cycles in which none of the embryos was considered "excellent quality" (n = 176). MAIN OUTCOME MEASURE(S): Rates of fertilization, pregnancy, "take-home baby," and multiple pregnancies. RESULTS: The average number of retrieved oocytes and the average number of inseminated oocytes of good quality were similar in both groups. Intracytoplasmic sperm injection was performed four to five times more often in cycles without "excellent quality" irrespective of the patient's age (odds ratio 4.6, 95% confidence interval 3.0, 7.1). The two groups had similar rates of implantation, total pregnancies/ET, clinical intrauterine pregnancy, singleton and multiple births, and "take-home" baby rate. This similarity persisted irrespective of the patient's age. CONCLUSION(S): The selection of oocytes for insemination and transfer of all available embryos irrespective of their quality did not change outcomes of ART.