GIFT Fertility treatments
Gamete Intra-Fallopian Transfer (GIFT) is a procedure in which the eggs are mixed with sperm and the mixture is then injected into the Fallopian tube. It is suitable for women who have at least one healthy Fallopian tube. The aim of GIFT is to allow fertilization to occur in the right place and implantation at the right time. One of the main differences between this procedure and in vitro fertilization (IVF) and zygote intrafallopian transfer (ZIFT) procedures is that the fertilization process takes place inside the fallopian tubes rather than inside the laboratory.

Who might benefit or who is recommended gamete intrafallopian tube transfer (GIFT)?

There are selected groups of patients to whom gamete intra-Fallopian transfer (GIFT) is recommended.

1.Men with infertility problem (not severe).
2.Couples who have had failed donor insemination.
3.Where transcervical embryo transfer is impossible and the patient has one healthy tube.
4.Couples with unexplained infertility.
5.Women with minimal endometriosis.

GIFT and ZIFT constitute less than 1% of all ART treatment in the USA (SART 2005 Report).

How is GIFT performed?

The procedure is carried out as a day case surgery under a general anaesthetic treatment and involves making three small cuts in the abdomen. Fertility drugs are used to stimulate the ovaries, monitoring is also carried out as with IVF treatment. Eggs may be collected either by a vaginal ultrasound scan or laparoscopically using a fine needle and gentle suction.

Once the eggs are collected, they are examined under the microscope for quality. The best eggs are then mixed with washed and prepared sperm in a small volume of culture medium. The end of the fallopian tube is grasped gently and a guided fine canula is passed through the fimbrial end of the tube. The mixture of the eggs and sperm is then deposited into the Fallopian tube.

The gamete intra-Fallopian transfer (GIFT) procedure.

Gamete intra-Fallopian transfer (GIFT) procedures are not regulated by the Human Fertilisation and Embryology Authority (HFEA) in the United Kingdom (provided that no donor eggs or donor sperm are used), so it is up to the clinician to decide how many eggs to transfer. However, in most cases, two or three eggs are usually transferred per cycle. Any spare eggs that are collected may be fertilized in-vitro and the resulting embryos are frozen (if they are of good quality to freeze) for later embryo replacement.

More recently, attempts have been made to simplify the procedure by collecting the eggs by vaginal ultrasound and injecting the egg and sperm mixture into the tube via the cervix using a special catheter. The procedure is usually performed under ultrasound guidance. The reported pregnancy rates with this method are less than that with conventional laparoscopy GIFT.

After the GIFT procedure, the patient is usually given hormonal supplements, in the form of tablets, pessaries, gel or injection to help the implantation of embryos.

The last step is to watch for early pregnancy symptoms. Your fertility specialist will probably use a blood test to determine if pregnancy has occurred.

Who should be treated with GIFT?

GIFT is an assisted reproductive procedure which may be the selected form of treatment for any infertility problems except the following:

1.An anatomic problem with the uterus, such as severe intrauterine adhesions.
2.Tubal blockage
3.Significant tubal damage

In general, in vitro fertilization (IVF) is a better approach for couples with male factor infertility.

GIFT is commonly chosen by couples who have failed to conceive after at least one year of trying and who have failed five to six cycles of ovarian stimulation with intrauterine insemination.

Choosing between GIFT and IVF treatment? OR What are the differences between GIFT and in vitro fertilization (IVF)?

There are several points worth considering when selecting between gamete intra-Fallopian transfer (GIFT) and in-vitro fertilization (IVF). The GIFT procedure is simpler and usually less stressful to the couple than IVF. However GIFT requires healthy Fallopian tubes, while IVF can be performed in women with absent or damaged tubes. GIFT also requires a general anesthetic, and its associated complications, while IVF can be performed under a local anesthetic. In addition, GIFT is associated with risks of injuries to bowels, bladder and blood vessels.

Some infertility clinics offer GIFT because it does not require a HFEA license (in the UK) and and requires less laboratory activity.

The Roman Catholic church remains strongly opposed to in-vitro fertilization (IVF), its objection grounded on the belief of catholic orthodoxy that human life begins at fertilization. As a result GIFT may be accepted as an alternative.

In IVF, fertilization takes place in the laboratory dish and can be confirmed visually under the microscope, while in GIFT, there is no way of knowing that fertilization has taken place unless the woman falls pregnant. For this reason, some specialists favor IVF than GIFT especially in unexplained infertility and in male factor infertility.

IVF has almost completely replaced GIFT and ZIFT and they are rarely performed nowadays.

What are the disadvantages?
GIFT is not as widely used as IVF because it involves the use of laparoscopy to insert the egg and sperm. An IVF embryo is transferred to the uterus via the vagina and cervix, which is a much less complicated procedure.

If no pregnancy occurs with GIFT, there’s no way of knowing for sure whether fertilisation took place at all. This is one reason why IVF may be recommended to some couples as a first option, as it will establish the ability of the man's sperm to fertilise the woman's eggs.

Your odds of having twins or triplets are greater with GIFT than natural conception because more than one egg may be transferred to your fallopian tubes. While you may welcome more than one baby, a multiple pregnancy increases your risk of miscarriage and other complications.

The fertility drugs used to stimulate egg production can have severe side effects, such as OHSS. You will need to be closely monitored while you are taking them.

GIFT also carries an increased risk of ectopic pregnancy, where an embryo implants in the woman’s fallopian tube or abdominal cavity.

Success of GIFT

Success in GIFT treatment is similar to that of IVF.

The success rate after GIFT is similar to that of in-vitro fertilization (IVF) treatment. Some specialists claim a higher success rate with GIFT compared to IVF.

Procedure	Live birth rate per embryo transfer cycle
IVF	31.0%
ICSI	28.6%
GIFT	24.5%
ZIFT	29.2%

Data adapted from SART report 2002

As with most fertility procedures, success depends on the couple's age and the woman's egg quality. It is estimated that approximately 25-30% of GIFT cycles result in pregnancy [1], with a third of those being multiple pregnancies. The First GIFT baby in the UK was Todd Holden born on the 23rd October 1986 in the Peterborough District Hospital.(WOW) The First GIFT baby in the US was Kaitlynne Kelley born on the 28th of April in 1987.

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