GIFT – Gamete Intrafallopian Transfer

The GIFT procedure involves the placement of gametes (oocytes and spermatozoa) into the fallopian tube. It is performed at the time of laparoscopic retrieval of oocytes from the ovaries, and thus does not require subsequent hospital admission.

Unlike the traditional In Vitro Fertilization/Embryo Transfer (IVF/ET), which involves the fertilization of the oocyte outside of the woman's body in the laboratory and reimplantation of the embryo into the uterus, the fertilization during the GIFT procedure takes place in the fallopian (uterine) tube.

Who is a candidate for GIFT?

Male:

Male patients with a low sperm count have poor chances to impregnate their partners by natural means. While insemination can improve these chances, if changes in the quality of sperm are severe, the GIFT procedure may be the best answer to the problem. As research in this area improves, success in the treatment of male infertility will be significantly improved. Right now, the success rate of GIFT procedures is significantly higher than that of conception of other means (IVF/ET or vaginal/cervical/intrauterine insemination).

Female:

Women play a major role during conception. Not only do they need to produce a fertilizable egg, they also need to release it, and the fallopian tube needs to pick it up and provide favorable surroundings for its fertilization. Any break in this process could cause a long-lasting or possibly indefinite infertility. Women who have a problem with any of the above functions, or who suffer from "unexplained infertility" are the primary candidates for the GIFT procedure. If one of the fallopian tubes is diseased, the chances for conception are reduced to 50%. Endometriosis is a frequent cause of infertility as well.

Clinical experiences seem to show that the GIFT procedure offers favorable chances to patients who suffer from infertility and qualify under the above categories. Many patients fail to conceive despite extensive therapy with fertility medications (Clomid, Pergonal, Lupron, hCG, Parlodel, etc.). Other investigations might show "normal" conditions. It has been our experience and the experience in other fertility centers that these cases of "unexplained infertility" are treatable by the GIFT procedure.

In addition, patients who have multiple failed regular IVF cycles may benefit from the GIFT procedure.

Testing prior to the GIFT Procedure

Proper consultation and investigation of the fertility problem are necessary in deciding if couples are candidates for the GIFT procedure. It is extremely helpful to provide information about previous medical care, diagnostic tests and therapy applied in the past. In certain cases, ovaries might not be accessible or visible at the time of laparoscopy and the route to recover eggs from the ovary has to be modified.

Useful Information

Female:

• The endocrinological status and regularity of menstrual periods and ovulation should be studied.
• Cultures for bacteria that might destroy the growing embryo should be obtained from the vagina and cervical opening.
• If necessary, inflammation of the uterine cavity will be excluded by endometrial biopsy.
• The immunological condition of the uterus might need to be studied.

Male:

• The quality of semen will be investigated: the number of cells per cc, the rate of motility, the quality of motion, normal and abnormal forms, etc.
• The semen will be cultured for the presence of bacteria and studied for the presence of inflammatory cells. Infection of the semen might be lethal to the embryo.
• When indicated, a test of the ability of the sperm to penetrate animal eggs might be ordered (hamster oocyte penetration assay).

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