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Some infertile couples are affected by conditions that prevent the sperm and egg from traveling through a fallopian tube, where fertilization and the first stage of cell division take place. The following are assisted reproductive technology (ART) procedures that are rarely used but may improve the chances of conception in the fallopian tubes. The first step of each of these treatment cycles is superovulation, the stimulation of multiple egg production with a series of hormone injections.
Gamete intrafallopian transfer (GIFT) uses multiple eggs collected from the ovaries, which are placed into a thin flexible tube (catheter) along with the sperm to be used. The gametes (both eggs and sperm) are then injected into the fallopian tubes using a surgical procedure called laparoscopy under general anesthesia.
Zygote intrafallopian transfer (ZIFT) combines in vitro fertilization (IVF) and GIFT. Eggs are stimulated and collected using IVF methods, then mixed with sperm in the laboratory. Fertilized eggs (zygotes) are then laparoscopically returned to the fallopian tubes where they will be carried into the uterus. The goal is for the zygote to implant in the uterus and develop into a fetus.
Pronuclear stage tubal transfer (PROST), similar to ZIFT, uses in vitro fertilization but transfers the fertilized egg to the fallopian tube before cell division occurs.
Because of the higher costs and risks related to laparoscopy, and the lesser amount of diagnostic information about embryo development compared with IVF, these procedures are rarely used.
Overall, assisted reproductive technology (ART)-related injections, monitoring, and procedures are emotionally and physically demanding of the female partner. Superovulation with hormones requires regular blood tests, daily injections (some of which are quite painful), and frequent monitoring by your doctor.
You can expect to return to daily activities after a routine laparoscopic procedure in less than a week.
GIFT may be appropriate when:
For GIFT or ZIFT, a woman must have at least one functional fallopian tube.
ZIFT and GIFT are used rarely enough that specific success rates aren't nationally available. But what is known about assisted reproductive technology (ART) includes the use of ZIFT and GIFT.
Risks resulting from laparoscopy (which may be used to collect eggs) include pelvic infection, puncture of internal organs, and side effects from general anesthesia.
Assisted reproductive technologies—including GIFT and ZIFT—increase the risk of multiple births. A multiple pregnancy is high-risk for both the mother and the fetuses.
In order for a woman over age 35 to maximize her chances of conceiving with her own eggs and carrying a healthy pregnancy, she must have more embryos transferred than a younger woman would. This increases her risk of multiple pregnancy.
Because of the risks to the babies of multiple pregnancy, experts recommend limiting the number of embryos transferred. Based on your age and your situation, your doctor will recommend a certain number of embryos to be transferred.
Women over 40 have a high rate of embryo loss when using their own eggs. As an alternative, older women can choose to use more viable donor eggs.
ART birth rates can be misleading. As a woman ages past her mid-30s, her egg quality and quantity decline, making it increasingly unlikely that an ART procedure using her own eggs will result in pregnancy and a healthy baby. Many women over age 40 choose to use donor eggs, which greatly improves their chances of giving birth to a healthy child.
ZIFT requires two separate procedures. The first procedure is to collect the eggs from the woman's ovaries. The second procedure is done several days later when the fertilized egg (zygote) is placed in her fallopian tube.
If GIFT fails, a doctor does not learn anything about the sperm's ability to fertilize the eggs. With in vitro fertilization, the sperm fertilizes the egg in the laboratory, where a health professional can tell whether fertilization has occurred and can follow embryo development.
ZIFT and GIFT procedures both cost approximately $15,000 to $20,000 for each attempt. In vitro fertilization usually costs less.
Last Revised: December 7, 2011
Author: Healthwise Staff
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