{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T11:06:51Z","timestamp":1784027211906,"version":"3.55.0"},"reference-count":23,"publisher":"Knowledge E DMCC","issue":"5","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":["knepublishing.com"],"crossmark-restriction":true},"short-container-title":["IJRM"],"abstract":"<jats:p>Background: Embryo quality is one of the most important factors influencing the success of assisted reproductive treatments.\r\nObjective: This study aimed to evaluate the effect of transferring poor-quality embryos along with good-quality embryos on intracytoplasmic sperm injection outcomes.\r\nMaterials and Methods: In this cross-sectional study, data of 124 women who underwent intracytoplasmic sperm injection and embryo transfer from January to December 2023 at Kamali hospital, Karaj, Iran were extracted from their medical records. Participants were classified into 3 groups: group 1 (n = 32) received only high-quality embryos (grades 1\u20132; A), group 2 (n = 34) received only poor-quality embryos (grades 3\u20134; B), and group 3 (n = 58) received a combination of both (A+B). Chemical pregnancy, clinical pregnancy, and miscarriage rates were measured.\r\nResults: Chemical pregnancy rates were 53.1%, 32.4%, and 44.8% in groups 1, 2, and 3, respectively (p = 0.227). Clinical pregnancy rates were significantly higher in group 1 (82.4%) compared with group 2 (54.5%) and group 3 (76.9%) (p = 0.001). Miscarriage rates were 17.6%, 27.3%, and 26.9%, respectively, with no significant difference (p = 0.81). Multivariate logistic regression adjusting for female age and body mass index confirmed that the embryo quality group was a significant independent predictor of clinical pregnancy. Compared to group 2 (only poor-quality embryos), the adjusted odds ratio for achieving a clinical pregnancy was 4.12 (95% confidence interval: 1.15\u201314.78, p = 0.030) for group 1 and 3.05 (95% confidence interval: 1.01\u20139.22, p = 0.048) for group 3.\r\nConclusion: Transfer of high-quality embryos (grade A) yielded the best pregnancy outcomes. However, when high-quality embryos are limited, transferring a combination of good- and poor-quality embryos may improve outcomes compared with transferring only poor-quality embryos.<\/jats:p>","DOI":"10.18502\/ijrm.v24i5.21289","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T10:37:27Z","timestamp":1784025447000},"update-policy":"https:\/\/doi.org\/10.18502\/knecrossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Does the transfer of a poor-quality embryo along with a good-quality embryo influence the intracytoplasmic sperm injection embryo transfer outcomes? A cross-sectional study"],"prefix":"10.18502","volume":"24","author":[{"given":"Ramesh","family":"Baradaran Bagheri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samaneh Sadat","family":"Hosseini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saba","family":"Hosseingholipour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shima","family":"Mohammadian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"7770","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"335939","doi-asserted-by":"crossref","unstructured":"[1] Vander Borght M, Wyns C. Fertility and infertility: Definition and epidemiology. Clin Biochem 2018; 62: 2\u201310.","DOI":"10.1016\/j.clinbiochem.2018.03.012"},{"key":"335940","unstructured":"[2] Ombelet W. WHO fact sheet on infertility gives hope to millions of infertile couples worldwide. Facts Views Vis Obgyn 2020; 12: 249\u2013251."},{"key":"335941","unstructured":"[3] Abangah GH, Rashidian T, Parizad Nasirkandy M, Azami M. A meta-analysis of the prevalence and etiology of infertility in iran. Int J Fertil Steril 2023; 17: 160\u2013173."},{"key":"335942","doi-asserted-by":"crossref","unstructured":"[4] Shokoohi M, Nasr Esfahani MH, Khaki AA, Ghazi Soltani G, Alihemmati A, Mohammadzadeh Boukani L. N-acetylcysteine improved expression of FSHR, LHCGR, Catsper-1, Catsper-2, and SF-1 genes in testis of rats with varicocele. Reprod Sci 2026; 33: 150\u2013160.","DOI":"10.1007\/s43032-025-02018-y"},{"key":"335943","doi-asserted-by":"crossref","unstructured":"[5] Nik Hazlina NH, Norhayati MN, Shaiful Bahari I, Nik Muhammad Arif NA. Worldwide prevalence, risk factors and psychological impact of infertility among women: A systematic review and meta-analysis. BMJ Open 2022; 12: e057132.","DOI":"10.1136\/bmjopen-2021-057132"},{"key":"335944","unstructured":"[6] Hasanpoor-Azghdy SB, Simbar M, Vedadhir A. The emotional-psychological consequences of infertility among infertile women seeking treatment: Results of a qualitative study. Iran J Reprod Med 2014; 12: 131\u2013138."},{"key":"335945","doi-asserted-by":"crossref","unstructured":"[7] Bakhtiyar K, Beiranvand R, Ardalan A, Changaee F, Almasian M, Badrizadeh A, et al. An investigation of the effects of infertility on women\u2019s quality of life: A case-control study. BMC Women\u2019s Health 2019; 19: 114.","DOI":"10.1186\/s12905-019-0805-3"},{"key":"335946","doi-asserted-by":"crossref","unstructured":"[8] Eftekhar M, Baradaran Bagheri R, Neghab N, Hosseinisadat R. Evaluation of pretreatment with cetrotide in an antagonist protocol for patients with PCOS undergoing IVF\/ICSI cycles: A randomized clinical trial. JBRA Assist Reprod 2018; 22: 238\u2013243.","DOI":"10.5935\/1518-0557.20180039"},{"key":"335947","doi-asserted-by":"crossref","unstructured":"[9] Wang J, Xiong S, Gao Y, Xia F, Wei B, Zou J, et al. Should ICSI be implemented on patients with poor-quality embryos in the previous IVF cycle? Heliyon 2023; 9: e17996.","DOI":"10.1016\/j.heliyon.2023.e17996"},{"key":"335948","doi-asserted-by":"crossref","unstructured":"[10] Baradaran Bagheri R, Salami SS, Mohammadzadeh Boukani L, Khaki AA. The regulatory effect of eugenol on FSHR, LHCGR, and ER expression during follicular development in female rats with ovarian torsion. Int J Women\u2019s Health Reprod Sci 2023; 11: 138\u2013144.","DOI":"10.15296\/ijwhr.2023.24"},{"key":"335949","doi-asserted-by":"crossref","unstructured":"[11] Hyun J-Y, Jung H-S, Park J-Y. Herbal therapeutics for female infertility: A systematic review and meta-analysis. J Ethnopharmacol 2024; 319: 117258.","DOI":"10.1016\/j.jep.2023.117258"},{"key":"335950","doi-asserted-by":"crossref","unstructured":"[12] Baradaran Bagheri R, Chavoshinezhad N, Barghi B, Soleymaniinallou M, Shokoohi M, Najafnezhad P, et al. Effects of Cornus mas extract (Anthocyanin) and treadmill exercise on hormonal and histological effects in the rat model of polycystic ovary syndrome. Int J Women\u2019s Health Reprod Sci 2025; 13: 37\u201343.","DOI":"10.15296\/ijwhr.2024.6004"},{"key":"335951","unstructured":"[13] Rehman R, Hussain Z, Fatima SS. Effect of weight status on pregnancy outcome in intra cytoplasmic sperm injection. Iran J Reprod Med 2013; 11: 717\u2013724."},{"key":"335952","unstructured":"[14] Moeini A, Amirchaghmaghi E, Javidfar N, Shahrokh Tehraninejad E, Sadeghi M, Khafri S, et al. The effect of body mass index on the outcome of IVF\/ICSI cycles in non polycystic ovary syndrome women. Int J Fertil Steril 2008; 2: 82\u201385."},{"key":"335953","doi-asserted-by":"crossref","unstructured":"[15] Zitzmann M, Rolf C, Nordhoff V, Schr\u00e4der G, Rickert-F\u00f6hring M, Gassner P, et al. Male smokers have a decreased success rate for in vitro fertilization and intracytoplasmic sperm injection. Fertil Steril 2003; 79: 1550\u20131554.","DOI":"10.1016\/S0015-0282(03)00339-X"},{"key":"335954","doi-asserted-by":"crossref","unstructured":"[16] Raad G, Tanios J, Kerbaj S, Shamas F, Fakih F, Mourad Y, et al. Stress management during the intracytoplasmic sperm injection cycle may slow down first embryo cleavage and accelerate embryo compaction: A pilot randomized controlled trial. J Psychosom Res 2021; 145: 110444.","DOI":"10.1016\/j.jpsychores.2021.110444"},{"key":"335955","doi-asserted-by":"crossref","unstructured":"[17] Peng M, Wen M, Jiang T, Jiang Y, Lv H, Chen T, et al. Stress, anxiety, and depression in infertile couples are not associated with a first IVF or ICSI treatment outcome. BMC Pregnancy Childbirth 2021; 21: 725.","DOI":"10.1186\/s12884-021-04202-9"},{"key":"335956","doi-asserted-by":"crossref","unstructured":"[18] Zeng C, Lu R-H, Li X, Wang S, Kuai Y-R, Xue Q. Effect of frozen-thawed embryo transfer with a poor-quality embryo and a good-quality embryo on pregnancy and neonatal outcomes. Reprod Biol Endocrinol 2024; 22: 26.","DOI":"10.1186\/s12958-024-01194-x"},{"key":"335957","doi-asserted-by":"crossref","unstructured":"[19] Xiao Y, Wang X, Gui T, Tao T, Xiong W. Transfer of a poor-quality along with a good-quality embryo on in vitro fertilization\/intracytoplasmic sperm injection-embryo transfer clinical outcomes: A systematic review and meta-analysis. Fertil Steril 2022; 118: 1066\u20131079.","DOI":"10.1016\/j.fertnstert.2022.08.848"},{"key":"335958","doi-asserted-by":"crossref","unstructured":"[20] Aldemir O, Ozelci R, Baser E, Kaplanoglu I, Dilbaz S, Dilbaz B, et al. Impact of transferring a poor quality embryo along with a good quality embryo on pregnancy outcomes in IVF\/ICSI cycles: A retrospective study. Geburtshilfe Frauenheilkd 2020; 80: 844\u2013850.","DOI":"10.1055\/a-1213-9164"},{"key":"335959","doi-asserted-by":"crossref","unstructured":"[21] Hill MJ, Eubanks AE, Csokmay JM, Christy AY, Jahandideh S, DeCherney AH, et al. Is transferring a lower-quality embryo with a good-quality blastocyst detrimental to the likelihood of live birth? Fertil Steril 2020; 114: 338\u2013345.","DOI":"10.1016\/j.fertnstert.2020.03.027"},{"key":"335960","unstructured":"[22] El-Danasouri I, Sterzik K, Rinaldi L, Pacchiarotti A, DeSanto M, Selman H. Effect of transferring a morphologically impaired embryo with a good quality embryo on the pregnancy and implantation rates. Eur Rev Med Pharmacol Sci 2016; 20: 394\u2013398."},{"key":"335961","doi-asserted-by":"crossref","unstructured":"[23] Wang W, Cai J, Liu L, Xu Y, Liu Z, Chen J, et al. Does the transfer of a poor quality embryo with a good quality embryo benefit poor prognosis patients? Reprod Biol Endocrinol 2020; 18: 97.","DOI":"10.1186\/s12958-020-00656-2"}],"container-title":["International Journal of Reproductive BioMedicine (IJRM)"],"original-title":[],"link":[{"URL":"https:\/\/knepublishing.com\/index.php\/ijrm\/article\/download\/21289\/32057","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/knepublishing.com\/index.php\/ijrm\/article\/download\/21289\/32057","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T10:48:32Z","timestamp":1784026112000},"score":1,"resource":{"primary":{"URL":"https:\/\/knepublishing.com\/index.php\/ijrm\/article\/view\/21289"},"secondary":[{"URL":"http:\/\/ijrm.ir\/article-1-3764-en.html","label":"UNIVERSITY"}]},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,14]]},"references-count":23,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,7,14]]}},"URL":"https:\/\/doi.org\/10.18502\/ijrm.v24i5.21289","relation":{},"ISSN":["2476-3772","2476-4108"],"issn-type":[{"value":"2476-3772","type":"electronic"},{"value":"2476-4108","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7,14]]}}}