Tubal selection for gamete intrafallopian transfer.

When both fallopian tubes appear normal, tubal selection for GIFT is left to the surgeon's discretion. We were interested to learn whether pregnancy rates were influenced by the choice of tubal transfer in relation to ovarian dominance. Ovarian dominance was defined sonographically as the ovary containing the greater number of follicles having a mean diameter > 16 mm. In a retrospective analysis of 144 GIFT procedures, the clinical pregnancy rate for transfers performed to the tube ipsilateral to the dominant ovary was significantly higher than that of transfers made to the contralateral tube (0.414 versus 0.228, P = 0.042). This difference could not be attributed to either patient characteristics or cycle performance. We suggest that gamete transfer be performed ipsilateral to the side with the greater number of dominant follicles to optimize pregnancy rates.