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PubMed1993

The value of serum beta-hCG in the prediction of pregnancy following gamete intrafallopian transfer.

Serum beta-hCG values in 149 GIFT pregnancies obtained on day 14 after oocytes retrieval and gamete intrafallopian transfer were evaluated. Mean beta-hCG value in multiple livebirths was higher than in the singleton and non-viable pregnancy groups and mean beta-hCG value in the latter two groups did not differ from each other. Serum beta-hCG level > or = 70 mIU/ml could be a suitable level to predict viable pregnancy with 72.8 per cent sensitivity and 92.85 per cent positive predictive values.

Chorionic Gonadotropin↗
PubMed1993

The role of gamete intrafallopian transfer (GIFT) and tubal embryo transfer (TET) in the treatment of patients with patent tubes associated with male infertility factor.

PURPOSE: The relative effectiveness of gamete intrafallopian transfer (GIFT) and tubal embryo transfer (TET) combined with superovulation in the treatment of infertile patients with patent tubes were compared. Four hundred fifty consecutive cycles were divided into two periods. During the first period (216 cycles), the only technique employed was GIFT, couples being divided into two groups: group A, couples with normospermic partners (118 cycles); and group B, couples with male infertility factor (98 cycles). During the second period (234 cycles), 140 cycles of GIFT were performed in couples with normospermic partners (group C). TET was utilized in 94 cycles (group D), in the case of couples with male infertility factor. RESULTS: Results demonstrate that the pregnancy rate with GIFT in the case of oligoasthenospermic partners (group B) is significantly lower than that of normospermic partners (groups A and C) (P = 0.0001) and than that with TET in the case of oligoasthenospermic partners (group D) (P = 0.0001). CONCLUSION: The implantation rate is also significantly different between these groups (B vs A, P = 0.0001; B vs C, P = 0.0001; B vs D, P = 0.01).

Embryo Transfer↗
PubMed1988

Gamete intrafallopian transfer and plasma chorionic gonadotropin dynamics: evidence of a delayed appearance.

The purpose of this study was to compare early human chorionic gonadotropin secretion in two groups of pregnancies. These pregnancies were obtained, in one group, during a natural cycle, while, in the other group, they resulted from gamete intrafallopian transfers performed in hyperstimulated cycles. A logarithmic regression analysis was chosen to allow statistical comparison of serial plasmatic evaluation as hormone determinations were obtained, among patients, at different postovulatory days. The regression lines of the two groups of patients presented similar slopes. The unpaired t test performed on calculated data for 3 different days constantly revealed significantly higher levels (P less than 0.005) of natural vs stimulated cycles; thus a different origin on the x axis (days of the luteal phase) is deduced. These findings support the possibility of a delay in the appearance of human chorionic hormone in the patients undergoing gamete intrafallopian transfer technique.

Chorionic Gonadotropin↗
PubMed1988

Programmed gamete intrafallopian transfer (GIFT).

Thirty-three patients with unexplained infertility underwent a total of 42 programmed superovulation cycles in a gamete intrafallopian transfer (GIFT) programme. The date of oocyte retrieval was decided in advance and the cycle preceding oocyte collection was modified with norethisterone from mid-cycle until 14 days before the scheduled laparoscopy. This was followed by a fixed schedule superovulation regimen. Serum oestradiol, progesterone and luteinizing hormone were monitored and the data analysed retrospectively. A single ultrasound scan was performed on the day of laparoscopy to exclude ovulation. Thirty-eight GIFT procedures were performed, resulting in 11 (29%) clinical pregnancies of which four twin and four singleton pregnancies are continuing. There was a significant correlation between the oestradiol response pattern and the maturity of oocytes retrieved, the fertilization rate of supernumerary oocytes and the pregnancy rate. Programmed cycles may be conveniently combined with GIFT, and basic endocrinological monitoring can be used to identify cycles with a poor prognosis before laparoscopy.

Adult↗
PubMedDate not supplied

Comparison of pregnancy rates following gamete intrafallopian transfer (GIFT) under general anesthesia with thiopental sodium or propofol.

STUDY OBJECTIVE: To determine whether the pregnancy rate for gamete intrafallopian transfer (GIFT) patients who received thiopental sodium was different from the pregnancy rate for patients who received propofol for the induction of general anesthesia. DESIGN: Retrospective review of clinical records. SETTING: Private outpatient infertility clinic. PATIENTS: Two hundred eighty-two consecutive GIFT procedures performed on 230 patients with infertility. INTERVENTION: Patients undergoing GIFT were divided into two groups on the basis of whether they received thiopental or propofol for induction of anesthesia. MEASUREMENTS AND MAIN RESULTS: Clinical pregnancy following each GIFT procedure was assessed by multiple-serum beta human chorionic gonadotropin and ultrasound determinations. The pregnancy rates of 24.6% and 25.8% for the thiopental and propofol groups, respectively, were not significantly different. CONCLUSIONS: The pregnancy rate following GIFT for patients given propofol for induction of general anesthesia did not differ from that for patients given thiopental.

Adult↗
PubMed1989

Attitudes and anxiety levels in women conceiving through in vitro fertilization and gamete intrafallopian transfer.

Anxiety and attitudes have been examined in a series of women conceiving through in vitro fertilization (IVF) and gamete intrafallopian transfer (GIFT). Women were assessed before and after their first ultrasound examination conducted between 6 and 8 weeks' gestation. A comparison group of women attending for genetic counseling for advanced maternal age also was assessed. The results showed the two patient groups to be comparable on psychological testing. The IVF-GIFT group tended to be more concerned about a problem developing but were not more anxious. Attitude ratings showed the IVF-GIFT women to have greater investment in the pregnancy and the fetus. A comparison of scores before and after the ultrasound showed anxiety reduction for women seeing the fetal heartbeat. Attitude ratings were more positive for the women seeing the fetal heartbeat, with change less pronounced in women denied this feedback. These results confirm the effects of diagnostic testing on emotional state. Women with IVF-GIFT pregnancies show both higher concern than documented elsewhere in low-risk pregnancies, as well as greater emotional investment in the fetus.

Adult↗
PubMed1992

Gamete intrafallopian transfer in women who had ectopic pregnancy previously.

Eighty-seven women who had previously had ectopic pregnancy underwent 111 gamete intrafallopian transfers (GIFT). Forty-one women had moderate or severe pelvic adhesions, eight had mild pelvic adhesions, and 18 had had the fallopian tubes surgically repaired. The remaining 20 women had no obvious pelvic abnormality except for the absence of one fallopian tube. After stimulation of superovulation, between two and 22 oocytes were retrieved and two to four were transferred into the fallopian tubes after careful assessment of their condition. Twenty-eight pregnancies were achieved (25.2% per cycle), with 23 live births (20.7% per cycle), four abortions (14.3% of all pregnancies), and one ectopic pregnancy (3.6% of all pregnancies, 0.9% per cycle). This experience shows that GIFT can safely produce a reasonable pregnancy rate in carefully selected women who have had ectopic pregnancy.

Adult↗
PubMed1987

Pregnancy after gamete intrafallopian transfer.

A couple with a history of 6 years' unexplained infertility was treated by gamete intrafallopian transfer (GIFT). Thus, oocytes were obtained by laparoscopy and immediately placed in a transfer catheter together with sperms. The oocyte/sperm preparation was injected into the Fallopian tube via a separate trochar under laparoscopic direction. Four weeks later pregnancy was confirmed by ultrasound.

Adult↗
PubMed2005

Endotoxic shock after gamete intrafallopian transfer.

OBJECTIVE: To report an extremely rare case of endotoxic shock due to Enterobacter cloacae that occurred after laparoscopy for gamete intrafallopian transfer (GIFT) in a nulligravid woman. DESIGN: Private fertility center in Cape Town, South Africa. SETTING: Case report. PATIENT(S): A 34-year-old woman with primary infertility. INTERVENTION(S): Routine preparation for GIFT procedure, sonar aspiration to obtain oocytes, followed by GIFT. Endotoxic shock developed within hours after the procedure, followed by admission to the intensive care unit, intravenous antibiotic therapy, mechanical ventilation, and abdominal hysterectomy. MAIN OUTCOME MEASURE(S): Preventing patient mortality and morbidity. RESULT(S): Discharge from the intensive care unit occurred on day 11 after GIFT, which was day 8 after surgery. A MEDLINE search (1980 to 2003) found no previous literature on endotoxic shock associated with assisted reproduction. CONCLUSION(S): Gram-negative infection with subsequent endotoxic shock after assisted reproductive techniques is extremely rare. As this case report shows, early diagnosis and active management of these cases are mandatory to prevent serious complications and mortality.

Adult↗
PubMed1997

Gamete intrafallopian transfer. Does smoking play a role?

OBJECTIVE: To investigate the effects of active and passive cigarette smoking on the outcome of gamete intrafallopian transfer (GIFT). STUDY DESIGN: A retrospective analysis of 98 patients who had laparoscopic GIFT was performed. Data were retrieved concerning age, diagnosis, amount of human menopausal gonadotropins (hMG) used for controlled ovarian hyperstimulation (COH), and number of oocytes retrieved and transferred. A detailed smoking history, if any, of patients and household members was obtained from chart review and an additional telephone survey. Pregnancy rates and outcome in active and passive smokers were compared to those of non-smokers. RESULTS: No difference was observed among active smokers (n = 19), passive smokers (n = 13) or nonsmokers (n = 66) regarding diagnosis, age percentage of mature oocytes retrieved or number of oocytes transferred during GIFT. However, active, but nor passive, smokers consumed a higher amount of hMG for COH as compared to nonsmokers. More important, pregnancy and live birth rates for active smokers (15.8% and 10.5%, respectively) were significantly lower than those for passive smokers (46.2% and 23.1%) and nonsmokers (45.5% and 33.3%). No difference, however, was noted between the latter two groups. CONCLUSION: Our results show that active, but not passive, smoking has a negative impact on GIFT pregnancy rates and outcomes. It is important to counsel patients against cigarette smoking prior to GIFT, but whether smoking cessation will improve the outcome needs further study.

Adult↗
PubMed1991

Ectopic pregnancy resulting from gamete intrafallopian transfer and in vitro fertilization. Role of ultrasonography in diagnosis and treatment.

Forty-five cases of ectopic pregnancy occurred after gamete intrafallopian transfer (32 cases) or in vitro fertilization (13 cases). Ultrasonography positively identified ectopic pregnancy in 33 cases (73.4%) and suggested the presence of one in 7 cases (15.6%). There were five false-negative results (11.1%). The incidence of rare types of ectopic pregnancy after assisted fertility procedures, such as ovarian, heterotopic, cervical and ectopic pregnancy, in patients who had undergone a previous salpingectomy was increased. Ultrasound scanning was used to monitor three cases of nonviable ectopic pregnancy; all three required no further treatment. In 14 cases of viable ectopic pregnancy the gestational sac was aspirated and injected with potassium chloride and methotrexate. In seven of those cases no further treatment was needed. Patients who conceive as a result of assisted fertility procedures should be scanned four to six weeks after the procedure or sooner if they are considered at high risk of developing an ectopic pregnancy or if the condition is symptomatic.

Abortion, Induced↗
PubMed1998

Gamete intrafallopian transfer. A cost-effective alternative to donor oocyte in vitro fertilization in women aged 40-42 years.

OBJECTIVE: To investigate whether gamete intrafallopian transfer (GIFT) may be a cost-effective alternative to donor oocyte procedures in women 40 and older with good ovarian reserve. STUDY DESIGN: Retrospective review of records at an infertility clinic in a large multispecialty group practice. Twenty two consecutive women aged 40 and older underwent 24 stimulation cycles for laparoscopic GIFT procedures from 1988 to 1997. RESULTS: The mean GIFT cycle cost was $5,731. The delivery rate per stimulation cycle was 25.0%. The patients who gave birth were 40-42 years of age. The mean cost per delivered infant was $22,924. A previously reported value for mean cost per pregnancy for donor oocyte in vitro fertilization (IVF) was $30,457. Theoretical costs per delivery, generated from Society for Assisted Reproductive Technology outcome data for anonymous donor oocyte IVF in 1994 (delivery rate per transfer, 34.4%) for $8,000, $9,000 and $10,000 cycle costs were $23,256, $26,163 and $29,070, respectively. CONCLUSION: In women with good ovarian reserve, GIFT may be a cost-effective alternative to donor oocyte IVF at age 40-42.

Adult↗
PubMed1993

Bilateral and unilateral gamete intrafallopian transfer (GIFT) are not equivalent therapies if unilateral GIFT is chosen to avoid one abnormal tube.

PURPOSE: The relative effectiveness of bilateral and unilateral gamete intrafallopian transfer (GIFT) was compared. Bilateral GIFT, where possible, was the preferred method of transfer and occurred in 328 patients. One hundred sixty-seven patients undergoing unilateral GIFT were placed into one of seven categories based on the indication for unilateral GIFT. Three categories included patients with either historical or laparoscopic evidence of unilateral tubal abnormalities, two categories included patients without tubal disease, and two categories contained patients in whom the physician could not choose between unilateral or bilateral GIFT. RESULTS: Results demonstrate that unilateral GIFT in patients with either historical or laparoscopic evidence of unilateral tubal disease had significantly lower pregnancy and implantation rates than patients undergoing bilateral GIFT or those undergoing unilateral GIFT without evidence of tubal disease (P < 0.01). CONCLUSION: The presence of unilateral tubal abnormalities predicts a lower likelihood of pregnancy in patients undergoing unilateral GIFT through the tube presumed to be normal.

Adult↗
PubMed1993

Health maintenance organizations; exclusion of gamete intrafallopian transfer and zygote intrafallopian transfer as basic health services--HCFA. Notice.

This notice informs the public of the determination by the Administrator of the Health Care Financing Administration that gamete intrafallopian transfer and zygote intrafallopian transfer are unusual, infrequently provided, and not necessary for the protection of individual health. This determination permits Federally qualified health maintenance organizations to exclude these services from the basic health services they must provide to their members.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1989

Gamete intrafallopian transfer vs superovulation with intrauterine insemination for the treatment of infertility.

Superovulation with intrauterine insemination (SO-IUI) has been suggested as an alternative to gamete intrafallopian transfer (GIFT), despite the absence of controlled or comparative trials. We retrospectively analyzed all GIFT and SO-IUI cycles performed concurrently from January 1985 to August of 1987 at a single university center. Pregnancy rates were significantly better for GIFT than SO-IUI (P less than 0.001), with an odds ratio of 3.25 (P = 0.001). Stepwise multiple logistic regression identified factors that correlate with pregnancy: absence of endometriosis (P = 0.05), infertility less than 3 years' duration (P = 0.002), TMS greater than or equal to 30 X 10(6) (P = 0.005), and treatment with GIFT rather than SO-IUI (P = 0.001). These data give a first approximation of the increased efficacy of GIFT versus SO-IUI and provide valuable insight into significant confounding variables to be considered when planning a randomized, prospective trial to evaluate these techniques.

Adult↗
PubMed1991

Gamete intrafallopian transfer by hysteroscopy as an alternative treatment for infertility.

OBJECTIVE: To evaluate efficacy and safety of the hysteroscopic cannulation by flexible catheter of the fallopian tubes for gamete intrafallopian transfer (GIFT). DESIGN: We studied the pregnancy rate (PR) and the safety of this new technique. SETTING: All patients were enlisted for GIFT at our Reproductive Medicine Unit. PATIENTS: We treated 26 patients whose infertility causes were terminal tubal damage, male factors, unexplained factors, and endometriosis. Patients with uterine tubal ostia unsuitable for gamete transfer or cervical incontinence were not included in the group. INTERVENTIONS: The patients underwent ovulation induction and oocyte retrieval by transvaginal ultrasonically guided puncture. The gamete transfers were carried out by hysteroscopic procedure using a flexible catheter put through the operating channel. MAIN OUTCOME MEASURE: The efficacy was evaluated by the PR (25.9%). RESULTS: Seven clinical pregnancies were obtained, but two patients aborted during the first weeks of pregnancy. No ectopic pregnancies were observed. CONCLUSIONS: Our results indicate that hysteroscopic GIFT is an alternative, safe, effective, and not invasive technique for fertility problems.

Adult↗
PubMed1988

Success rate in gamete intrafallopian transfer using low and high concentrations of washed spermatozoa.

The effect of a reduced number of spermatozoa on pregnancies and miscarriages was studied retrospectively in 307 consecutive gamete intrafallopian transfer (GIFT) cycles. The number of spermatozoa introduced per GIFT in each group was as follows: 100,000 (group I), 50,000 (group II), 10,000 (group III), 5,000 (group IV), and 2,500 (group V), which gave a pregnancy rate of 20%, 38%, 37%, 30%, and 24%, respectively (differences were not significant). With respect to the pregnancies, no correlation was found between the number of spermatozoa transferred and the cause of infertility. In the male factor group also no significant difference was observed in the pregnancy rate when the sperms were reduced from 100,000 to 2,500. Lowering the number of sperms in GIFT did not reduce the abortion rate, which remained around 33%. It was the patients with unexplained infertility who benefited most from the GIFT procedure. Their pregnancy rate was significantly higher than the pregnancy rate of those who had endometriosis, or andrologic or immunologic disorders.

Adult↗