Selective reduction after gamete intrafallopian transfer.

Selective reduction was performed in a patient with triplet pregnancy in the 9th week of gestation. Selective reduction of the fetuses to two was performed by puncture using vaginal ultrasound probe. No complications occurred and the patient was delivered of healthy twins.     

经阴道配子输卵管内移植42例临床分析

目的开展经阴道配子输卵管内移植（ｔｒａｎｓｖａｇｉｎａｌｇａｍｅｔｅｉｎｔｒａｆａｌｏｐｉａｎｔｒａｎｓｆｅｒ,ＴＶＧＩＦＴ）技术并探讨其实用价值。方法１９９６年５月至１９９７年１０月,对证实至少有一条以上输卵管正常的不孕患者４２例（４３个周期）,采用卵泡刺激素、绝经期促性腺激素、人绒毛膜促性腺激素（ＦＳＨｈＭＧ／ｈＣＧ）及ｈＭＧ／ｈＣＧ超排卵方案,经阴道穿刺取卵,改良上游法处理精液,以ＪａｎｓｅｎＡｎｄｅｒｓｅｎ输卵管导管系统行ＴＶＧＩＦＴ,平均移植卵子（４．０±０．９）个／周期。结果输卵管插管成功率６７．４％（２９／４３）,临床妊娠１３例,双胎５例,周期妊娠率３０．２％（１３／４３）;９例分娩（出生婴儿１３个）,４例流产。结论ＴＶＧＩＦＴ适用于至少一侧输卵管通畅的不孕患者,技术简便,易于掌握,无需开腹及腔镜操作,有较高的妊娠成功率,值得开展推广     

Contralateral tubal pregnancy after gamete intrafallopian transfer.

A case of EP after GIFT into the contralateral tube is presented. Hydrotubation with Earle's medium immediately before the GIFT cannot be excluded as a possible cause of gamete migration. The complete demise of the CL also demonstrates that trophoblast can implant and develop without steroidal support.     

Culdoscopic gamete tubal transfer: a new approach to gamete intrafallopian tubal transfer.

Twelve infertile couples who failed to conceive by previous infertility treatments and who qualified for culdoscopy had oocyte retrieval and gamete transfer through an operative culdoscopy method. Six patients achieved clinical pregnancy. Five are ongoing pregnancies, and one patient miscarried. There were no complications of the procedures.     

Pregnancies in cancelled gamete intrafallopian transfer cycles

Forty-four percent of started GIFT cycles were cancelled. Insemination and intercourse in the cancelled cycles yield a 23% and 10% pregnancy rate, respectively.     

Clomiphene citrate-induced gamete intrafallopian transfer with diagnostic and operative laparoscopy.

STUDY OBJECTIVE: To examine the efficacy of clomiphene citrate (CC) gamete intrafallopian transfer (GIFT) with operative laparoscopy. DESIGN: Retrospective. SETTING: Private office and outpatient surgical center. PATIENTS: Sixty-two patients who were to undergo diagnostic and operative laparoscopy as part of their infertility evaluation underwent concomitant CC-stimulated GIFT. Any significant pelvic pathology was treated in conjunction with the GIFT procedure. RESULTS: The average number of oocytes retrieved per laparoscopy was 3.4 and an ongoing pregnancy rate (PR) of 24.6% was attained. Endometriosis, pelvic adhesive disease, and myoma were treated laparoscopically in conjunction with the GIFT procedure. CONCLUSION: Clomiphene citrate-induced GIFT in conjunction with diagnostic and operative laparoscopy results in an acceptable ongoing PR without significantly interfering with any operative laparoscopy procedure required.     

Programmed gamete intrafallopian transfer (GIFT)

Summary. Thirty-three patients with unexplained infertility underwent a total of 42 programmed superovulation cycles in a gamete intrafallopian transfer (GIFT) programme. The date of oocyte retrieval was decided in advance and the cycle preceding oocyte collection was modified with norethisterone from mid-cycle until 14 days before the scheduled laparoscopy. This was followed by a fixed schedule superovulation regimen. Serum oestradiol, progesterone and luteinizing hormone were monitored and the data analysed retrospectively. A single ultrasound scan was performed on the day of laparoscopy to exclude ovulation. Thirty-eight GIFT procedures were performed, resulting in 11 (29%) clinical pregnancies of which four twin and four singleton pregnancies are continuing. There was a significant correlation between the oestradiol response pattern and the maturity of oocytes retrieved, the fertilization rate of supernumerary oocytes and the pregnancy rate. Programmed cycles may be conveniently combined with GIFT, and basic endocrinological monitoring can be used to identify cycles with a poor prognosis before laparoscopy.     

Preliminary experiences with gamete intrafallopian transfer (GIFT)

This article describes the first series of patients to undergo gamete intrafallopian transfer (GIFT) as a treatment for infertility. Ten patients with the diagnosis of either unexplained infertility or male factor were treated with human menopausal gonadotropin and human chorionic gonadotropin before surgery by laparoscopy or minilaparotomy. Semen was collected 2.5 hours before oocyte pickup at surgery and treated by the technique of wash and swim-up. After gamete evaluation, one or two oocytes and 100,000 actively motile sperm were loaded into a catheter and introduced through the fimbria. The contents of the catheter were gently emptied at a site approximately 1.5 cm inside each fallopian tube. Patients received progesterone in oil, 12.5 mg/day, from day 4 after GIFT until up to 8 weeks of gestation. Four patients became pregnant: two pregnancies aborted; the other two pregnancies proceeded to the delivery of viable infants. GIFT may be considered as an alternative to in vitro fertilization in infertility cases in which at least one fallopian tube is patent.     

Programmed gamete intrafallopian transfer (GIFT)

Thirty-three patients with unexplained infertility underwent a total of 42 programmed superovulation cycles in a gamete intrafallopian transfer (GIFT) programme. The date of oocyte retrieval was decided in advance and the cycle preceding oocyte collection was modified with norethisterone from mid-cycle until 14 days before the scheduled laparoscopy. This was followed by a fixed schedule superovulation regimen. Serum oestradiol, progesterone and luteinizing hormone were monitored and the data analysed retrospectively. A single ultrasound scan was performed on the day of laparoscopy to exclude ovulation. Thirty-eight GIFT procedures were performed, resulting in 11 (29%) clinical pregnancies of which four twin and four singleton pregnancies are continuing. There was a significant correlation between the oestradiol response pattern and the maturity of oocytes retrieved, the fertilization rate of supernumerary oocytes and the pregnancy rate. Programmed cycles may be conveniently combined with GIFT, and basic endocrinological monitoring can be used to identify cycles with a poor prognosis before laparoscopy.     

Hysteroscopy for gamete intrafallopian transfer (GIFT)

Gamete intrafallopian transfer (GIFT) is performed currently using laparoscopy. We report on a pilot-study from 1.1.1987 to 31.12.1987 and from 1.5.1988 to 30.4.1989, in which we used hysteroscopy instead of laparoscopy for the GIFT-procedure. The entering conditions were: unexplained (idiopathic) infertility, failure of previous treatments, proven fertilization capability of the gametes in at least one IVF attempt, and request of the married couple to dispense with laparoscopy during GIFT procedure. Hysteroscopic GIFT was initially performed on hysterectomy specimens, using the Chorionoskop. Continuous flow CO2 through the fallopian tubes did not result in loss of gametes. Twenty-four treatment cycles were performed in 16 patients. In 19 cycles, gametes were transferred into one tube, and in two cycles they were transferred into both tubes. Four of 16 women conceived: one patient delivered at term, three pregnancies ended in a first trimester abortion. These results demonstrate that the hysteroscopic approach to intrafallopian gamete transfer can be successful. However, the technique is demanding and requires extensive training. We conclude that further improvements of hysteroscopic GIFT are needed.     

Pregnancy following gamete intrafallopian transfer: A case report

Conclusion Although more data are needed and it is still too early for a definitive conclusion, GIFT can probably offer new perspectives not only in the treatment of unexplained infertility but also in cases of persistent infertility in patients with LUF (luteinzed unruptured follicle) or a mild degree of endometriosis or when no conception occurs after surgical correction of endometriosis.Only further prospective studies will help us to determine the indications for GIFT.     

Births after transcervical gamete intrafallopian transfer with a falloposcopic delivery system

Objective: To evaluate the safety and efficiency of a new delivery system to perform transcervical GIFT.

Design: Evaluation of pregnancy rate (PR), miscarriage rate, ectopic pregnancy rate, and delivery rate.

Setting: Institute of Obstetrics and Gynecology, Reproductive Endocrinology Unit, Infertility and IVF Center.

Patient(s): Twenty-five patients with patent tubes documented by laparoscopy plus falloposcopy.

Intervention(s): Superovulation was induced with GnRH analogue and FSH. Under laparoscopic control, transcervical cannulation of the tube was done using a linear everting catheter incorporating direct falloposcopic vision of the tubal lumen. Two lengths of everting catheter (3 and 6 cm) were used providing either isthmic-ampullary or midampullary placement of the inoculum. A comparison was done in terms of ease of access and transfer, falloposcopic observations, and PRs between the groups.

Main outcome measure(s): Efficacy was established by evaluating the PR, miscarriage rate, ectopic pregnancy rate, and delivery rate.

Result(s): The PR was 28% (with no differences between the lengths of everting catheters). No ectopic pregnancies occurred. The abortion rate was 28.6% and the delivery rate was 20%. Neither tubal perforation nor other complications occurred during the procedure.

Conclusion(s): Falloposcopic GIFT is safe and efficient and may be a less invasive alternative than laparoscopic transfer.     

A laparoscopic approach to a program of gamete intrafallopian transfer

Gamete intrafallopian transfer (GIFT) provides an effective method of achieving pregnancy in infertile women with normal fallopian tubes. Laparoscopic approach to ovum pickup and tubal catheterization provides a simple and rapid means of performing the operation. Equipment used to facilitate this process is described, and techniques of tubal catheterization are discussed. A clinical pregnancy rate of 27% is reported in a series of 71 treatment cycles. The application of GIFT in conjunction with in vitro fertilization is discussed, especially the use of excess gametes to provide embryos for freezing. The use of GIFT as a research and investigative tool may provide further insight into the causes for idiopathic infertility.     

Early experience with in vitro fertilization-embryo transfer and gamete intrafallopian transfer in a Nigerian hospital

We present our early experience with in vitro fertilisation-embryo transfer (IVF-ET) and gamete intrafallopian transfer (GIFT) in a Nigerian Hospital. Twenty-one patients were recruited, 11 patients for the IVF-ET program and 10 for the GIFT program. In the IVF program the oocyte recovery rate was 100%, the fertilization rate was 66% and the cleavage rate was 97% but no live pregnancies were achieved. In contrast, one live delivery was achieved with GIFT. These results suggest that both IVT-ET and GIFT are feasible in developing countries.     

Simultaneous in vitro fertilization and gamete intrafallopian transfer (GIFT)

During a 6-month period, a combination of gamete intrafallopian transfer (GIFT) and in vitro fertilization (IVF) was offered to all couples beginning an IVF treatment cycle in whom the wife had anatomically normal fallopian tubes. It was recommended to these couples that sufficient oocytes be reserved for insemination in vitro to determine whether the husband's spermatozoa could fertilize the wife's oocytes. During this interval, 16 couples underwent the combined IVF-GIFT procedure. All of the IVF-GIFT couples had at least two oocytes inseminated in vitro and at least two oocytes for GIFT. Of the 16 IVF-GIFT couples, only 1 (6.25%) achieved a clinical pregnancy. More important, 50% (8/16) of the IVF-GIFT couples had no oocytes fertilized in vitro. With the information concerning lack of fertilization in vitro, appropriate recommendations concerning future fertility management can be made. If the same couples had undergone the GIFT procedure alone, without additional oocytes fertilized in vitro, this information would not have been obtained.