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What is GIFT?
GIFT is similar to IVF. The woman's ovaries are stimulated to produce more eggs than usual, the eggs are collected, and the man needs to produce sperm (although donor sperm can be used). When egg collection has taken place, two eggs are mixed together with the sperm in a dish.
The main difference from IVF is that with GIFT the gametes (eggs and sperm) are immediately transferred to the woman's fallopian tubes, so fertilisation occurs inside, not outside, the woman's body. The embryo can begin its earliest development in natural surroundings rather than in an artificial environment.
ZIFT (Zygote Intrafallopian Transfer) is a similar procedure to GIFT, except that it is the newly fertilised egg (zygote) which is returned to the woman's fallopian tubes rather than the mixture of eggs and sperm.
This procedure shares the advantage of GIFT in that any resulting embryo will immediately be able to develop in the natural surroundings of your body. However, it's a much more invasive process than GIFT, involving two procedures instead of one: egg retrieval and then a separate laparoscopy to insert the embryo.
Fertility experts usually prefer to use IVF rather than GIFT or ZIFT because it is less invasive and there is more control over the quality of the resulting embryos. However, GIFT is still more likely to be used than ZIFT. For this reason the rest of this article is devoted to GIFT.
Fertility treatment: Gamete Intrafallopian Transfer (GIFT)
GIFT may be used when there is a low sperm count, or sperm with poor motility (ability to move) and for couples with unexplained infertility.
How is it done?
As its name suggests, GIFT takes advantage of a woman's fallopian tubes as a natural incubator for fertilisation. Aside from that difference, this procedure is identical to a standard in vitro fertilisation (IVF) treatment.
You'll be given fertility drugs to stimulate your ovaries to develop several mature eggs for fertilisation. (You normally release only one egg a month.)
When the eggs are mature, your doctor locates the eggs with the help of ultrasound and removes them from your ovaries using a fine, hollow needle. Minutes later, one or two of your eggs will be combined with your partner's sperm.
Immediately after, in a minor surgical procedure, the doctor transfers the eggs and sperm to your fallopian tubes, which lead from your ovaries to your uterus. Your doctor will do this using a fibre-thin tube either through a small incision in your abdomen or via a catheter passed through your cervix.
This sets the scene for natural fertilisation and implantation to take place. You'll need to rest for a short time after the procedure and then you'll be given progesterone to help the lining of the uterus to build up ready for implantation. Progesterone can be given by injection, pessary or gel.
How long does the treatment take?
From start to finish, one complete cycle of GIFT takes four to six weeks. With GIFT, egg retrieval and gamete transfer happens in the same operation. Even though this is minor surgery, you can go home the same day.
What is the success rate?
Outcomes vary greatly depending on your particular fertility problem and on your age. Younger women usually have healthier eggs and higher success rates. The chance of success with GIFT is around 30 to 40 per cent.
What are the advantages?
Your doctor may suggest GIFT over IVF if both your fallopian tubes are intact and you have personal or religious reasons for wanting to avoid IVF.
It's a technique that can be used in preference to IVF where there is a problem inserting an embryo via the vagina and cervix.
What are the disadvantages? `
GIFT is not as widely used as IVF because it involves the use of laparoscopy to insert the egg and sperm. An IVF embryo is transferred to the uterus via the vagina and cervix, which is a much less complicated procedure.
If no pregnancy occurs with GIFT, there's no way of knowing for sure whether fertilisation took place at all. This is one reason why IVF may be recommended to some couples as a first option, as it will establish the ability of the man's sperm to fertilise the woman's eggs.
Your odds of having twins or triplets are greater with GIFT than natural conception because more than one egg may be transferred to your fallopian tubes. While you may welcome more than one baby, a multiple pregnancy increases your risk of miscarriage and other complications.
GIFT also carries an increased risk of ectopic pregnancy, where an embryo implants in the woman's fallopian tube or abdominal cavity.
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