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Gamete intrafallopian transfer (GIFT) is a form of assisted reproduction which may be used as an alternative to in vitro fertilization (IVF) in certain circumstances. It is undertaken as a single day-case episode and requires less embryological expertise than IVF. GIFT has been successfully carried out in a number of district general hospitals. The details of the procedure as presently undertaken in Wigan are described.
Gamete intrafallopian transfer (GIFT) was performed on 77 women with endometriosis in 92 cycles with or without concomitant laser therapy or electrofulguration of endometriosis. The pregnancy rates were 45% for laser cases, 25% for electrofulguration cases and 36.4% for GIFT only. The pregnancy rate for stage III endometriosis was 53% versus 14% and 47% for stages II and I, respectively. Although there was a trend toward an increased pregnancy yield with active therapy, no statistically significant difference was achieved. The postoperative fecundity in patients not conceiving with GIFT was poor for all the groups.
Gamete intrafallopian transfer (GIFT) provides an effective method of achieving pregnancy in infertile women with normal fallopian tubes. Laparoscopic approach to ovum pickup and tubal catheterization provides a simple and rapid means of performing the operation. Equipment used to facilitate this process is described, and techniques of tubal catheterization are discussed. A clinical pregnancy rate of 27% is reported in a series of 71 treatment cycles. The application of GIFT in conjunction with in vitro fertilization is discussed, especially the use of excess gametes to provide embryos for freezing. The use of GIFT as a research and investigative tool may provide further insight into the causes for idiopathic infertility.
The birth of the first baby following in-vitro fertilisation and embryo transfer (IVF/ET) in 1978 and the introduction of gamete intrafallopian transfer (GIFT) in 1984 have increased the treatment modalities in operative reproductive medicine. In tubal pathology, there are besides micro-surgery now so-called additive methods available for treating infertility. With regard to the indications, there has been severe confusion, and it is therefore imperative to define special indications for IVF/ET, microsurgery and GIFT. We do not consider these treatment modalities as alternative methods. Reproductive centres should offer all these treatments to guarantee an appropriate individual programme for each couple. Therefore, knowledge of pregnancy rates is a prerequisite for the doctor. The aim of this paper is, to define the optimal therapy while taking into account the individual problems of each couple.
Gamete intrafallopian transfer (GIFT) is performed currently using laparoscopy. We report on a pilot-study from 1.1.1987 to 31.12.1987 and from 1.5.1988 to 30.4.1989, in which we used hysteroscopy instead of laparoscopy for the GIFT-procedure. The entering conditions were: unexplained (idiopathic) infertility, failure of previous treatments, proven fertilization capability of the gametes in at least one IVF attempt, and request of the married couple to dispense with laparoscopy during GIFT procedure. Hysteroscopic GIFT was initially performed on hysterectomy specimens, using the Chorionoskop. Continuous flow CO2 through the fallopian tubes did not result in loss of gametes. Twenty-four treatment cycles were performed in 16 patients. In 19 cycles, gametes were transferred into one tube, and in two cycles they were transferred into both tubes. Four of 16 women conceived: one patient delivered at term, three pregnancies ended in a first trimester abortion. These results demonstrate that the hysteroscopic approach to intrafallopian gamete transfer can be successful. However, the technique is demanding and requires extensive training. We conclude that further improvements of hysteroscopic GIFT are needed.
Gamete intrafallopian transfer (GIFT) is traditionally performed by delivering gametes into the ampullary region of either one or two fallopian tubes. The choice is made by the surgeon at the time of laparoscopy based upon the patient's anatomy, the number of oocytes available, and clinical judgment. In this nonrandomized, retrospective review, 399 tubal gamete transfers were performed over a period of 18 months, 133 to a single tube and 266 to both tubes. A clinical pregnancy rate of approximately 24% was observed in each modality. The multiple pregnancy rate of 31.3% for one tube was not significantly different from the 25% seen for two tubes. Unilateral tubal transfer offers the distinct advantages of less gamete and tissue handling. This, along with the apparent same outcome parameters, makes unilateral tubal transfer the preferred method of returning gametes at GIFT.
Gamete intrafallopian transfer has been performed since April 1985 in our hospital. In patients with a long history of infertility despite proved tubal patency, the follicles present at laparoscopy are aspirated. The oocytes thus obtained are introduced together with the prepared sperm via a special catheter directly into the ampulla. We would like to report on the first pregnancy for which we used this technique.
Gamete intrafallopian transfer (GIFT), developed in 1984, was the result of further studies on in vitro fertilization (IVF). Since that time many nurses have worked in settings near in vitro fertilization centers and, therefore, have a basic understanding of the technology. An overview is given of the GIFT procedure to prepare nurses to advise and refer couples who may qualify for GIFT and to highlight the shift in the fertility program nurse coordinator's functions toward the positions of administrator and consultant.
Gamete intrafallopian transfer (GIFT) was performed on a series of 42 couples in whom four oocytes were replaced into the fallopian tubes and the remaining oocytes were inseminated with 100,000 motile spermatozoa. Fertilization in vitro was assessed 16 to 20 hours later. An overall pregnancy rate after GIFT of 40.0% (12/30) in normospermic couples and 16.7% (2/12) in oligospermic couples was seen. Supernumerary oocytes were submitted to in vitro fertilization (IVF) and the findings related to the likelihood of pregnancy. No correlation between IVF and the likelihood of GIFT pregnancies was found in either the oligospermic or normospermic couples. A similar proportion of pregnancies was seen in couples with or without evidence of fertilization of the supernumerary oocytes in both the oligospermic and normospermic couples. However, a high proportion of normospermic couples with no evidence of fertilization had only one oocyte remaining for insemination. These results suggest that the failure of low numbers of supernumerary oocytes to fertilize in vitro after GIFT relates to oocyte selection criteria and does not mean a reduced chance of conception in that treatment cycle.
Gamete intrafallopian transfer (GIFT) was applied in 207 treatment cycles in 73 couples. The pregnancy rate in cycles with only one (2/21, 9.5%) or two (2/29, 6.9%) oocytes transferred was significantly less than that in which four oocytes (36/116, 31.0%) were replaced. The collection of more than four oocytes did not influence the pregnancy rate in that treatment cycle. The overall pregnancy rate was 24.2% (50 of 207) and was similar in the four infertility groups studied (non-occlusive tubal disorders, endometriosis, cervical factor and unexplained infertility) with 28 (56%) of the pregnancies delivered at greater than or equal to 20 weeks. The pregnancy wastage included 4 (8%) ectopic pregnancies and 3 (6%) late pregnancy losses. The 12 multiple pregnancies occurred following the transfer of three and four oocytes.
Gamete intrafallopian transfer (GIFT) is a new technique of assisted conception appropriate for women with normal fallopian tubes. As 60% of infertile patients have normal and patent tubes (idiopathic infertility, immune causes, male infertility and endometriosis) they can be treated with this technique which is both simpler and more successful than in vitro fertilization.
We present our early experience with in vitro fertilisation-embryo transfer (IVF-ET) and gamete intrafallopian transfer (GIFT) in a Nigerian Hospital. Twenty-one patients were recruited, 11 patients for the IVF-ET program and 10 for the GIFT program. In the IVF program the oocyte recovery rate was 100%, the fertilization rate was 66% and the cleavage rate was 97% but no live pregnancies were achieved. In contrast, one live delivery was achieved with GIFT. These results suggest that both IVT-ET and GIFT are feasible in developing countries.
Methods for the collection and transfer of equine oocytes have been developed, and uses of these techniques have resulted in new clinical and research possibilities. Because oocyte transfer avoids reproductive problems associated with the oviduct, uterus, and cervix, pregnancies can be produced from many mares that cannot carry a pregnancy or produce embryos. Oocytes for clinical transfers are usually collected from preovulatory follicles and cultured for a short interval or transferred directly into a recipient's oviduct. For oocyte transfer, the recipient is inseminated within the uterus. A large number (1 x 10(9) to 2 x 10(9)) of motile sperms are preferred for inseminations. In contrast, sperm and oocyte are transferred into the oviduct during gamete intrafallopian transfer (GIFT). Therefore, a lower number (1 x 10(5) to 2 x 10(5)) of sperm can be used. Potentially, GIFT could be used in situations where sperm numbers are limited. Use of oocyte transfer and GIFT in clinical and research settings will aid us in understanding the interactions between oocyte, sperm, and oviduct in the equine.
OBJECTIVE: To analyze whether a policy of high-order oocyte transfer would be effective in women > or = 40 years of age who are undergoing GIFT, and further, whether a specific subgroup of these patients could be identified where clinical pregnancy was more likely to occur. DESIGN: Prospective descriptive study. SETTING: Patients in a university-based reproductive endocrinology and infertility practice. PATIENTS: Infertile women > or = 40 years of age who underwent GIFT cycles between January, 1990 and December, 1993 after not having achieved pregnancy with at least three previous cycles of superovulation and intrauterine insemination. INTERVENTIONS: Gamete intrafallopian transfer was performed after controlled ovarian hyperstimulation with hMGs. High-order oocyte transfer was employed. MAIN OUTCOME MEASURES: Clinical pregnancy rates (PRs). RESULTS: The overall clinical PR was 24.5% per retrieval (12/49) and 25.5% per transfer (12/47). A significantly higher number of oocytes were retrieved in patients who became pregnant than those who did not. Patient age, cycle day 3 FSH level, E2 level on the day of hCG administration, number of oocytes transferred, and total number of motile sperm transferred did not differ significantly between the two groups. The clinical PR per transfer was significantly higher in patients with more than five oocytes transferred (10/27, 37%) versus those with five or less oocytes transferred (2/20, 10%). No multiple gestations were obtained. CONCLUSION: The number of oocytes retrieved in women > or = 40 years of age undergoing GIFT is the main determinant predicting clinical pregnancy. High-order oocyte transfer seems to lead to a favorable PR while the risk of multiple gestation is limited.
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Gamete intrafallopian transfer involves a direct transfer of both human gametes, sperm and oocytes, into the fallopian tube. Since the first report of a successful pregnancy following the use of this technique by Asch et al in 1984, its role in the treatment of infertile women with patent tubes has been established. Recent data demonstrate a 34.4% clinical pregnancy rate, with the highest pregnancy rate achieved in infertile women due to endometriosis or unexplained infertility.
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OBJECTIVE: To determine the availability of donated cryopreserved embryos. DESIGN: Retrospective review. SETTING: Community hospital-based donor oocyte program. PATIENT(S): Eighty-nine consecutive infertile couples and women who had 94 sets of embryos cryopreserved after pregnancy initiation with unfertilized donated eggs between January 1, 1991 and December 31, 1996. INTERVENTION(S): Cryopreservation of fertilized ova or cleaving embryos. MAIN OUTCOME MEASURE(S): Disposition of frozen embryos as of June 1, 1997. RESULT(S): Of the 94 sets of frozen embryos, 52 (55.3%) were thawed into the original recipient. At an average of 30 months since the treatment cycle, 26 (27.7%) sets of embryos remain in storage. Of the 16 sets of embryos not thawed for transfer, 11 sets (11.7%) were donated and 5 sets (5.3%) were destroyed. The fraction of spare embryos donated was much higher after pregnancy initiation with unfertilized donated eggs than after IVF-ET and GIFT (68.8% versus 19.1%, respectively). CONCLUSION(S): Couples and women who did not use their frozen embryos after pregnancy initiation with unfertilized donated eggs were twice as likely to donate them as to have them destroyed. Secondary donation of cryopreserved embryos was much more common after pregnancy initiation with unfertilized donated eggs than after standard IVF-ET and GIFT.