Comparison of concurrent pregnancy rates for in-vitro fertilization-embryo transfer, pronuclear stage embryo transfer and gamete intra-Fallopian transfer

Concurrent pregnancy and implantation (sacs/embryos transferred)rates were compared for 84, 77 and 49 cases of in-vitro fertilization–embryotransfer (TVF–ET), pronuclear stage embryo transfer (PROST)and gamete intra-Fallopian transfer (GIFT), respectively. Allcases reported occurred during an 18-month interval since theinitiation of PROST by our programme. Leuprolide acetate wasused with follicle stimulating hormone and human menopausalgonadotrophin for follicular stimulation of all but donor oocytecases (n = 9). Clinical pregnancy (per transfer) and implantationrates were significantly higher (P < 0.03) for PROST (52.4%,20.2%) in comparison with IVF–ET (26.9%, 11.4%). Ratesfor GIFT (48.9%, 18.4%) were not significantly higher (P = 0.10,0.14) than for IVF—ET. This was probably due to the lowernumber of GIFT than PROST procedures performed. The total pregnancyrate for GIFT (biochemical, ectopk and clinical combined) wassignificantly greater (P < 0.05) than for IVF—ET. Pregnancyand implantation rates for PROST and GIFT were similar. Theseresults support the use of PROST rather than IVF—ET forall cases in which the woman has one functional Fallopian tube.Furthermore, to maintain equivalent rates of pregnancy withPROST and GIFT, it is suggested that GIFT should not be usedfor cases of male-factor infertility without first documentingnormal rates of in-vitro fertilization with PROST.