Gamete Intrafallopian Transfer

Gamete intrafallopian transfer (GIFT) is a form of assisted reproductive technology (ART). Instead of placing the sperm and eggs in a petri dish in the laboratory, as with in vitro fertilization (IVF), the gametes (medical terms for eggs and sperm) are placed in the fallopian tubes. This way, the embryo develops in the woman’s body, not outside of the body.

 

Why choose gamete intrafallopian transfer?

Certain couples do not wish to have IVF due to religious or cultural reasons. The only form of assisted reproductive technology (ART) allowed by the Catholic Church is GIFT. This is because conception is a natural process with gamete intrafallopian transfer, and embryos do not go through a screening process, as with zygote intrafallopian transfer (ZIFT).

 

Who is a candidate for gamete intrafallopian tube transfer?

As with other methods of ART, GIFT is not for every couple. If the woman has blockage of the fallopian tubes, the resulting embryo cannot pass down the tube to the uterus. Candidates for this procedure include:

  • Women with ovulation problems (infrequent ovulation or premature menopause)
  • Men with poor sperm quality (motility issues or low sperm count)
  • Women with cervical abnormalities (prevent the sperm front entering the uterus)
  • Women who have mucus that is hostile to sperm
  • Women with endometriosis (that doesn’t block fallopian tubes)
  • Couples who have physical problems that make sex difficult
  • Women over the age of 35 years

 

How successful is GIFT?

The frequency of gamete intrafallopian transfer is quite low compared to in vitro fertilization. Regardless, around 25% of GIFT cycles result in pregnancy. With IVF, assisted hatching and blastocyst embryo transfer can increase the success rates. Actual success with GIFT depends on the maternal age, the underlying cause of the infertility, and the condition of the sperm and eggs before they are transferred.

 

How is GIFT done?

The first step of the GIFT process involves stimulating the woman’s ovaries to produce and release multiple eggs. Taking hormones encourages several ovarian follicles to develop. To check the size of the follicles, ultrasound technology is used. Egg retrieval takes place approximately 10-14 days after hormone treatment starts. Right before egg retrieval, the male’s sperm is collected for washing (concentration). Egg retrieval is done using a small, thin catheter passed up the vaginal wall and through the abdominal cavity, which is done using ultrasound-guidance.

To avoid multiple births, only 2-3 eggs are combined sperm and placed in a thin tube. The solution of sperm and eggs is transferred into the female’s body using laparoscopy. This requires a small incision to be made in the abdomen. The entire process takes a few hours. After the couple returns home, the woman must take certain medications to help the uterus lining (endometrium) mature. If fertilization occurs, the resulting embryo(s) implant 5-7 days later.

 

What can go wrong with GIFT?

When more than one egg is transferred to the fallopian tube, there is a chance of multiple pregnancy. Most fertility centers only transfer up to three eggs for women 39 years of age and younger, and four for women 40 years and older. This decreases the risk of multiple eggs being fertilized and implanting. Other risks of gamete intrafallopian transfer include:

  • Ectopic pregnancy – The embryo implants too soon into the fallopian tube.
  • Infection – This rarely occurs, but because GIFT is an invasive procedure, there is a slight chance of infection.
  • Ovarian hyperstimulation – The drugs used to stimulate the ovaries can produce hyperstimulation, which causes abdominal pain, nausea, bloating, and irritability.
  • Treatment failure – Not all couples get pregnant with GIFT.