What is GIFT?
With gamete intra-fallopian transfer (GIFT), the preparation and monitoring of the growth of eggs is identical to in vitro fertilisation (IVF).
One of the main differences between this procedure and in vitro fertilization (IVF) and zygote intrafallopian transfer (ZIFT) procedures is that with GIFT the fertilization process takes place inside the fallopian tube rather than in a laboratory. However, healthy tubes are necessary for GIFT to work.
Is GIFT for me?
GIFT has been used with some success in cases where:
- a couple has unexplained infertility
- the woman’s fallopian tubes aren’t blocked or damaged
- the man has a low sperm count, or there are problems with the sperm
- there are objections to IVF on religious or other reasons
- IVF has failed to result in a successful pregnancy.
However, the clinical guidelines on fertility issued by NICE (the National Institute for Health Clinical Excellence) state:
‘There is insufficient evidence to recommend the use of gamete intrafallopian transfer … in preference to in vitro fertilisation in couples with unexplained fertility problems or male factor fertility problems.’
How does GIFT work?
Step 1. Before proceeding with GIFT, it is essential that your fallopian tubes are known to be open and healthy. A tubal patency test is usually carried out as part of your assessment by the fertility clinic.
Step 2. Prior to any GIFT, IVF, or ICSI procedure, the woman receives hormones to stimulate development of the ovarian follicles, which are sac-like structures that contain the eggs. Administering these hormones allows us to retrieve many ripened eggs, and thus increase the chance of pregnancy.
Step 3. You will be anaesthetised and your doctor will make a small 5mm cut at the umbilicus. This is so they can insert a laparoscope to view your womb and fallopian tubes.
Step 4. Under direct vision through the laparoscope, eggs are removed from the ovaries. This may require two additional small incisions in the lower abdomen. Alternatively eggs may be harvested by transcervical route via ultrasound guidance.
Step 5. Approximately three hours before the procedure, a semen sample from the husband is obtained. The sperm is washed and prepared for loading into the same catheter into which several of the wife’s best eggs will be placed.
Up to three of the best quality eggs, if you are below the age of 40, or up to four eggs if you are over 40 are then mixed with the prepared sperm in a catheter (a fine, flexible tube).
Step 6. The doctor inserts the catheter via the laparoscope into the end of one or both fallopian tubes and deposits the eggs and sperm.
Step 7. You need a short rest before going home. You will be given medication to build up the lining of your womb and provide a good environment for any fertilised eggs.
What are the differences between GIFT and in vitro fertilization (IVF)?
- With IVF, the eggs are fertilized in a laboratory rather than in the fallopian tubes as with GIFT.
- IVF can be used with couples in which the female does not have fallopian tubes or has blocked fallopian tubes.
- IVF allows for fertilization confirmation and assessment of embryo quality.
- GIFT does not involve fertilization outside of the body, so couples do not have to deal with the ethical concerns with choosing which embryos to transfer.
How long does GIFT take?
It takes four to six weeks to complete one cycle of GIFT.
You have to wait for your eggs to mature. Then you and your partner spend about half a day at the doctor’s office or clinic, having your eggs and sperm retrieved and surgically transferred to the fallopian tube.
Laparoscopy is minor surgery, so you’ll be able to go home the same day.
What’s the success rate for GIFT?
The outcomes of GIFT vary dramatically, depending on each couple’s reasons for infertility and their ages. Younger women usually have healthier eggs and higher success rates. After using GIFT, the average pregnancy rate is about:
- 37 percent for women age 38 and younger
- 24 percent for women age 39 and older
The percentage of GIFT cycles resulting in a live birth (meaning at least one baby is born) is similar to IVF success rates – about 22 percent.
What are the pros of GIFT?
- Natural conception. Conception occurs in the fallopian tube, rather than in the laboratory. This might appeal to you if you’d like your baby to develop as naturally as possible, or if you have specific religious beliefs against conception outside the body. However, there are no medical reasons why natural fertilization is preferable to assisted fertilization.
- No link to cancer. Recent studies have shown no connection between ovulation-inducing fertility drugs and cancer. (Early studies suggested that exposure to fertility drugs might lead to a higher risk of ovarian cancer or other cancers of the female reproductive system.)
What are the cons of GIFT?
- Costly and time-consuming. GIFT requires expensive lab work, drugs, and surgery. Monitoring your response to fertility drugs also requires a lot of time, with frequent trips to the doctor’s office for blood tests and ultrasounds.
- Requires surgery. Transferring eggs and sperm to your fallopian tube requires invasive surgery, unlike IVF.
- Odds of multiples. Because more than one egg is usually placed in the fallopian tube, you’re more likely to have twins or other multiples. A large study of GIFT cycles found that if three or four eggs were transferred, the pregnancy rate for twins or triplets was almost 22 percent. (The rate of conceiving twins without fertility treatment is less than 1 percent.) Though many couples consider this a blessing, carrying multiples increases your risk of miscarriage and other complications.
- Other health risks. As in IVF, you have a higher risk of ectopic pregnancy or developing ovarian hyperstimulation syndrome (OHSS) due to taking fertility medications that cause multiple follicles to mature.
- It may not work. The treatment could be cancelled if you’re experiencing OHSS or if not enough follicles develop.