The impact of Italian legislative amendments on delivery rate: a matched case control study

In May 2009, the Italian Constitutional Court declared unconstitutional the 40/2004 restrictive law of the Italian Parliament, granting the physician the possibility to define the optimal number of oocytes to be inseminated, the number of embryos to be transferred and allowing cryopreservation of embryos. To investigate the effect of suspension of the restrictive human ART law in Italy on the characteristics and efficiency of a routine infertility program, a one-to-one matched case-control study was conducted before and after the Court sentence (182 cycles for both groups, respectively). Mean number of inseminated oocytes was 2.9 and 7.5 in the preand postsentence groups, respectively (p< 0,001). A lower mean number of embryos per patient was transferred in the post-sentence group (2.5 vs 2.1; p< 0.001). Although comparable cumulative delivery rates were obtained in both periods, fewer cycles per patient were performed in the post-sentence group (mean: 1.6 vs 1.4; p<0.01). In conclusion, inseminating more than 3 oocytes and performing embryo selection allows a reduction in the number of embryos to be transferred and/or cryopreserved while maintaining the same chance to obtain a delivery.