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At least 127 records · Page 7Linked to original sources
PubMed1992

Cost-effectiveness of gamete intrafallopian transfer in comparison with induction of ovulation with gonadotropins in the treatment of female infertility: a clinical trial.

OBJECTIVE: To compare the cost-effectiveness of gamete intrafallopian transfer (GIFT) with that of conventional infertility treatment in couples with female infertility, excluding tubal factors. DESIGN: Patients were randomly divided in two groups: receiving GIFT or conventional infertility treatment. For a period of 2 years, GIFT was compared with conventional infertility treatment in couples with endometriosis, anovulation, idiopathic infertility, cervical mucus factor, female immunologic factor, or multifactorial causes of infertility in a randomized clinical trial. SETTING: The study was performed in the Unit for Human Reproduction, Department of Obstetrics and Gynaecology, Faculty of Medicine, University of the Orange Free State, Bloemfontein, Republic of South Africa. PATIENTS: One hundred seventy-four successive couples with female infertility were selected for the study. All couples were from the higher socioeconomic bracket. INTERVENTIONS: One group received GIFT and the other received conventional infertility treatment consisting of induction of ovulation with gonadotropins followed by intrauterine artificial insemination or normal intercourse. MAIN OUTCOME MEASURES: The results were stratified according to the specific cause of infertility. Outcome was measured by the success rate per treatment cycle, as well as the cost per pregnancy. RESULTS: Overall, GIFT proved to be successful in 26.7% of treatment cycles compared with 9.7% with conventional therapy. CONCLUSIONS: After careful analysis, the authors came to the conclusion that GIFT is more cost-effective than conventional infertility treatment in patients with endometriosis and anovulation. In patients with idiopathic infertility, immunologic infertility, a cervical mucus factor, and multifactorial infertility, induction of ovulation followed by intrauterine artificial insemination or normal intercourse proved to be more cost-effective.

Coitus↗
PubMed1990

Peripheral blood platelet counts in the management of very early pregnancy failure following gamete intrafallopian transfer.

Early pregnancy-associated thrombocytopenia has been described previously in the peripheral blood of in vitro fertilization (IVF) patients and is evaluated here in 26 women undergoing gamete intrafallopian transfer (GIFT). No consistent fall in platelets was seen in ongoing pregnancies. It is suggested that a fall in peripheral blood platelets in the early luteal phase may be observed only in pregnancies where more than one embryo is present.

Chorionic Gonadotropin↗
PubMed2004

The effect of advancing paternal age on pregnancy and live birth rates in couples undergoing in vitro fertilization or gamete intrafallopian transfer.

OBJECTIVE: This study was undertaken to determine effects of male aging on sperm parameters, fertilization, pregnancy, and live birth rates among in vitro fertilization (IVF) or gamete intrafallopian transfer (GIFT) couples. The impact of female age was also investigated. STUDY DESIGN: Prospective study was made up of 221 IVF and GIFT couples. RESULTS: Pregnancy rates declined as the male subjects aged. Each additional year of paternal age was associated with 11% increased odds (P=.007) of not achieving a pregnancy, and 12% odds (P=.01) of not having a successful live birth. For first-time IVF/GIFT recipients, each additional year of paternal age was associated with a 5% increased odds of not achieving a pregnancy, whereas for repeaters it was 40% (P=.01). Advancing maternal age was associated with decreased numbers of oocytes retrieved or fertilized. Women 40 years or older compared with younger than 35 years had greater than 4-fold risk of not becoming pregnant, and greater than 20-fold risk of not achieving a live birth. CONCLUSION: Advancing paternal (and maternal) age had a deleterious effect on IVF and GIFT outcomes.

Adult↗
PubMed1990

Outpatient gamete intrafallopian transfer: a clinical analysis of 710 cases.

From February 1986 to June 1989 445 infertile couples were treated with a total of 710 treatment cycles involving laparoscopic gamete intrafallopian transfer (GIFT). The median age of the female partner was 33.5 years (range, 24 to 49 years) and the median duration of infertility was 4 years (range, 2 to 20 years). The final outcome of all 217 clinical pregnancies is known. There were 150 live births among which all but one baby survived, comprising 112 singleton births, 28 twin births, nine triplet births and one quadruplet birth. There were no still births, but there were two premature, multiple live births (one triplet, one quadruplet) among which no babies survived the neonatal period. Overall, 40 of the 152 potentially viable pregnancies were multiple (26.3%). Three of 206 potentially viable babies were born with congenital anomalies (1.5%). There were 50 clinical spontaneous abortions (24.8% of uterine pregnancies), one termination of pregnancy for Down's syndrome, and 14 ectopic pregnancies rate was 30.6% per laparoscopy and, among 740 initiated cycles, a live and surviving birth-per-initiated-cycle rate of 20.2%, or 33.7% to date per couple entering the programme. The 710 laparscopies resulted in two serious complications (0.3%), one of which required laparotomy. Eight other patients were admitted to hospital for rest and observation because of painful ovarian enlargement in the luteal phase. The total inpatient admission rate was 1.4%. Outpatient laparoscopic GIFT under general anaesthesia is a safe and effective procedure when conventional treatment for infertility has been unsuccessful.

Abortion, Spontaneous↗
PubMed1991

Progesterone response to exogenous gonadotropins after suppression with leuprolide acetate in gamete intrafallopian transfer.

Fifty-three cycle of ovarian stimulation with human menopausal gonadotropins after suppression of endogenous gonadotropin release with leuprolide acetate were completed for the purpose of performing gamete intrafallopian transfer. Thirty-seven biochemical pregnancies resulted, with 29 progressing to clinical status, for rates of 69.8% and 54.7%, respectively, per cycle. In comparing characteristics of the follicular recruitment phases of failed cycles to those of cycles resulting in pregnancies, no differences were observed in serum estradiol concentrations or follicular development. However, pregnancy rates were highly associated with peak concentrations of progesterone prior to the administration of human chorionic gonadotropin. Three levels of progesterone range were found on the basis of outcome: 6 high-progesterone cycles produced no pregnancies (0%), 32 mid-range progesterone cycles produced 31 pregnancies (97%), and 15 low-progesterone cycles produced six pregnancies (40%). The pregnancy rate in the last group improved when the luteal support was doubled.

Adult↗
PubMed1995

In vitro fertilisation and gamete intrafallopian transfer: an integrative analysis of research, 1987-1992.

OBJECTIVE: To provide a statistically integrated analysis and review of all published outcome studies of in vitro fertilisation (IVF) and gamete intrafallopian transfer (GIFT) occurring in English language journals between 1987 and 1992; to provide information regarding outcome of assisted reproduction not otherwise available from national registers; and to assess correspondence of these outcomes with outcome data presented in the national registers of the Fertility Societies of Australia and the United States. DESIGN: Computer literature review and manual search of major infertility journals to identify all papers reporting clinical pregnancy rates for IVF and GIFT. A secondary analysis of three factors, including 1. treatment (IVF vs GIFT), 2. stimulation protocol [combinations using clomiphene citrate (CC), combinations using gonadotrophin agonists (GnRHa), and combinations using neither clomiphene citrate nor gonadotrophin agonists, (designated by the symbols and acronyms approximately CC approximately GnRHa throughout this article)], and 3. cause of infertility, assessed their impact upon three clinical pregnancy rates: 1. cycles commenced, 2. cycles reaching retrieval and 3. cycles reaching oocyte/embryo transfer, via a series of one-way analyses of variance with either planned contrasts or post hoc comparisons. SUBJECTS: The unit of observation was the published study. Data were obtained from 31 journals and 216 papers, containing 509 samples and 39,754 per cycles commenced. Data from the national registers of the Fertility Societies of Australia and the United States were used for comparison of literature-based outcomes, where appropriate. RESULTS: The concordance between the outcomes reported in the national registers of Australia and the United States and the amalgamated literature-based data was such that cautious confidence was placed in the results of the subsequent analyses of the literature-based data which provided information not otherwise available. GIFT resulted in significantly more clinical pregnancies than IVF for each stage of the treatment cycle. Differences in pregnancy rates between IVF and GIFT were 8.6% more pregnancies for GIFT for cycles commenced, 14.2% for cycles reaching retrieval, and 7.5% for cycles reaching oocyte or embryo transfer. Stimulation protocols using gonadotrophin agonists (GnRHa) resulted in more clinical pregnancies than protocols using clomiphene citrate for each stage of the treatment cycle: from commencement (10.22%), to retrieval (8.36%), and to transfer (9.36%). Interaction effects indicated that GIFT-GnRHa combinations were superior to IVF-clomiphene citrate combinations for all rates. For cycles reaching retrieval and transfer, GIFT-GnRHa resulted in significantly more clinical pregnancies than IVF-GnRHa. GIFT-clomiphene citrate was better than IVF-clomiphene citrate and IVF-GnRHa was better than IVF-clomiphene citrate. Women with endometriosis (Stages I or II) achieved higher rates of clinical pregnancy than participants with other causes of infertility. CONCLUSIONS: Significantly higher pregnancy rates for GIFT and GnRHa were demonstrated in this study. It was argued that since the differences in clinical pregnancy rates were smaller between IVF and GIFT when a GnRHa protocol was employed, the apparent superiority of GIFT may in fact be due, at least in part, to GnRHa. This question needs further prospective investigation. Women with endometriosis (Stage I or II) achieved higher pregnancy rates than those with other causes of infertility. Overall, this study provides confirmation that well-held clinical conclusions have a true basis in the published literature and that the published literature reflects population data reported in national registers. Further prospective research is needed to clarify the unique probabilities of a live birth for individual couples.

Chorionic Gonadotropin↗
PubMed1990

Clinical and biochemical pregnancy in two respective recipients without ovarian function following gamete intrafallopian transfers using oocytes from a single donor.

Infertility resulting from premature ovarian failure in two independent patients was treated using a combination of steroid replacement, oocyte donation and gamete intrafallopian transfer (GIFT). Following ovarian stimulation four oocytes were retrieved from a volunteer donor undergoing simultaneous laparoscopic sterilisation. Two oocytes were subsequently replaced into each recipient's fallopian tube together with capacitated sperm from their respective husbands. In one recipient (Turner's syndrome) an intrauterine sac with fetal heart present was observed by ultrasound six weeks post GIFT whereas in the second recipient (premature menopause) plasma beta-hCG reached a peak value of 954mIU/ml eighteen days after GIFT before decreasing rapidly in the absence of ultrasound evidence of pregnancy. Intramuscular administration of progesterone appeared to be necessary during the post-GIFT period for maintenance of pregnancy. The above treatment was carried out on a predominantly out-patient basis in a small assisted conception unit based in a teaching hospital.

Adult↗
PubMed2000

Complete hydatidiform mole coexisting with a live fetus after gamete intrafallopian transfer. A case report.

BACKGROUND: Molar pregnancy with a coexisting live fetus is a rare occurrence. We report the only known case with a surviving coexistent fetus after gamete intrafallopian transfer (GIFT). CASE: After GIFT, a 28-year-old primary infertility patient was diagnosed as having a complete hydatidiform mole coexisting with a live fetus at 13 weeks of gestation. At 36 weeks of gestation, a cesarean section was performed due to elevated serum human chorionic gonadotropin (hCG) levels, and a male infant with a normal appearance and weighing 2,688 g was delivered. CONCLUSION: If the patient desires to try to carry the fetus to viability after counseling on the possible associated risks of malignancy, it is possible to achieve fetal viability if (1) there is decline in the serum hCG level after it peaks before the second trimester, (2) ultrasound reveals degeneration of the molar part, and (3) there are no complications of pregnancy.

Adult↗
PubMedDate not supplied

Gamete intrafallopian transfer (GIFT): use of minilaparotomy and an individualized regimen of induction of follicular development.

The performance of the gamete intrafallopian transfer (GIFT) technique, utilizing an individualized regimen of follicular induction and minilaparotomy in 45 patients with infertility of varying etiologies is reported. The induction regimen consisted of the administration of clomiphene citrate, 100 mg, from day 3 to day 7, and 150 IU FSH/LH (human menopausal gonadotropin [hMG]) from day 6 on. Human chorionic gonadotropin (hCG; 10,000 IU) was administered when at least two follicles measured 16 mm or more in diameter and when serum estradiol (E2) measurement revealed levels of 350 pg/ml per each main follicle. Up to two oocytes and 100,000 motile sperm were transferred to the fallopian tubes via the fimbria, using a catheter. Of the 45 cases, 13 became pregnant by clinical criteria (29 per cent). Of these 13 pregnancies, nine continued to term (69 per cent), three miscarried spontaneously (12 per cent) and one was an ectopic (7 per cent). Of the nine pregnancies that continued to term, five (55 per cent) were twins. Details of the GIFT procedure as well the preliminary non-human primate research studies that led to the development of the GIFT technique are discussed. It is concluded that GIFT is an excellent alternative to in vitro fertilization and embryo transfer (IVF; ET) in all cases of infertility that failed to conceive using conventional forms of therapy and in which the female partner presents at least one normal fallopian tube.

Animals↗
PubMedDate not supplied

Effect of semen characteristics on pregnancy rate in a gamete intrafallopian transfer program.

The aim of this study was to evaluate the influence of sperm morphology, swim-up concentration, and insemination volume on pregnancy outcome in patients undergoing gamete intrafallopian transfer (GIFT) treatment in whom the male partner had a morphology of less than 14%. Only patients who received four oocytes were entered into this study (n = 103). In all cases the swim-up procedure time was standardized to 1 h and the insemination concentration was standardized to 500,000 per oviduct. There was no significant difference in pregnancy rate when normal morphology, swim-up concentration, or insemination volume were used as predictors. In the P pattern group (< 4% normal forms) only four of the 28 (14%) patients had ongoing pregnancies, whereas in the G pattern group (5% to 14% normal forms) 16 out of 75 (21%) had ongoing pregnancies (P vs G, p > 0.05; not significant). The fertilization rate among excess oocytes in the P pattern group was 18% but was 39% (p < .0001) in the G pattern group. When an attempt was made to compensate for low morphology by increasing insemination concentration no significant difference in the pregnancy rate between the P and G pattern groups in the GIFT program was recorded. This was not the case when the in vitro fertilization rate was used as an endpoint. Insemination volume and swim-up concentration played no role in pregnancy rate.

Female↗
PubMed1990

Multiple-sited (heterotopic) pregnancy after in vitro fertilization and gamete intrafallopian transfer.

Pregnancies occurring simultaneously in different body sites (heterotopic pregnancies) are a rare condition thought to occur in 1 of 30,000 spontaneous pregnancies. Individual cases may occur after in vitro fertilization (IVF) or gamete intrafallopian transfer (GIFT). In the past 4 1/2 years, our unit has performed 6,204 IVF/GIFT or pronuclear stage transfer cycles of treatment. Ten such pregnancies proven by surgical, ultrasound, and histological diagnosis have occurred. In the same period 640 IVF, 355 GIFT, and 6 pronuclear stage transfer clinical pregnancies were achieved. This suggests that the incidence of heterotopic pregnancy after assisted reproduction is closer to 1 of 100 pregnancies. Clinicians managing early complications of IVF, GIFT, and/or pronuclear stage transfer pregnancies should be aware of this relatively high incidence of concomitant intrauterine and extrauterine pregnancy.

Female↗
PubMed1991

Successful use of gamete intrafallopian transfer does not reverse the decline in fertility in women over 40 years of age.

To assess the impact of assisted reproductive technologies on the potential fertility of older women, we report our experience with gamete intrafallopian transfer (GIFT) in a large number of women 40 years of age and older. One hundred twenty-two GIFT cycles were initiated in 59 women over 18 months. Seventy-three tubal transfers were performed, resulting in seven clinical pregnancies, a rate of 9.6% per transfer. This contrasts with a 27.3% clinical pregnancy rate per transfer in women under 40. Thus, older patients require thorough counseling regarding the decreased likelihood of success despite the use of assisted reproductive technologies.

Adult↗
PubMed1990

Comparison of different ovarian stimulation protocols for gamete intrafallopian transfer in patients with minimal and mild endometriosis.

Three different stimulation protocols were tested in patients affected by stage I and II endometriosis with no other causes of infertility, and scheduled for the gamete intrafallopian transfer technique. In two protocols a gonadotropin hormone-releasing hormone analog was used. The analog was started 6 months before stimulation in the former and along with the exogenous gonadotropin in the latter. Patients receiving only gonadotropin served as controls. Sixty patients were selected for this study; 55 reached laparoscopy. Whereas patients receiving either gonadotropin alone or simultaneous analog and gonadotropin had similar pregnancy rates, this was much higher in the patients undergoing a prolonged, medically induced hypoestrogenism. Prolonged analog pretreatment before ovarian stimulation may give better chances of success in endometriosis patients undergoing assisted reproduction techniques.

Adult↗
PubMed1992

In vivo fertilization procedures in infertile women with patent fallopian tubes: a comparison of gamete intrafallopian transfer, combined intrauterine and intraperitoneal insemination, and controlled ovarian hyperstimulation alone.

This prospective study was undertaken to evaluate the relative efficacy of three in vivo methods of assisted fertilization in 150 infertile women with patent fallopian tubes: gamete intrafallopian transfer (GIFT), combined intrauterine and direct intraperitoneal insemination (IUI+DIPI), and controlled hyperstimulation (COHS) alone. The clinical pregnancy rate was highest in the IUI/DIPI and GIFT groups: IUI/DIPI, 29.3%; GIFT, 28.6%; and COHS, 8.9%. We believe that controlled ovarian hyperstimulation combined with IUI and DIPI is a good alternative to GIFT.

Adult↗
PubMed1987

A controlled study between the use of gamete intrafallopian transfer (GIFT) and in vitro fertilization and embryo transfer in the management of idiopathic and male infertility.

A randomized controlled trial comparing the use-effectiveness between gamete intrafallopian transfer (GIFT) and in vitro fertilization (IVF) and embryo transfer (ET) procedures showed no significant difference in pregnancy rates in the management of patients presenting with idiopathic or male infertility. The cost-effectiveness of GIFT appears superior to IVF and ET with laparoscopic oocyte collection, but comparable to IVF-ET with ultrasonic oocyte collection. The lack of data on the fertilizing capacity of sperm in GIFT procedures in cases of male infertility is a real disadvantage and currently precludes the management of severe male infertility with this method.

Adult↗
PubMed1993

Comparison of cycle outcome for gamete intrafallopian transfer alone and in combination with intrauterine embryo transfer.

As an alternative to embryo cryopreservation, the efficacy of intrauterine transcervical transfer of a small number of embryos resulting from fertilization of supernumerary oocytes obtained during a GIFT cycle (GIFT-ET) was assessed in this investigation. Data from 72 consecutive GIFT (N = 27) and GIFT-ET (N = 45) cycles were retrospectively reviewed. Age and infertility diagnoses were similar among the two groups. Clinical pregnancy, ongoing pregnancy, and abortion rates per retrieval were not significantly different between the two groups. We conclude that GIFT-ET offers no advantage over GIFT alone and that cryopreservation of all supernumerary embryos with intrauterine transfer in subsequent cycles would maximize pregnancy rates from a single oocyte aspiration and GIFT procedure.

Adult↗