One of a variety of relatively new infertility treatments, gamete intrafallopian transfer, or GIFT, offers an alternative to in vitro fertilization (IVF). In many ways, GIFT is similar to IVF, but rather than bringing the egg and sperm together in laboratory conditions for fertilization, GIFT allows fertilization to occur within the fallopian tubes, as would happen under normal circumstances. GIFT was developed in the 1980s and remains a viable option for many couples struggling with infertility.
Harvesting the Eggs
The first step of GIFT involves harvesting the egg cells from the woman involved in the procedure. As with IVF and many other fertility procedures, she is given a fertility drug that stimulates follicles in the ovaries to produce multiple eggs. Under normal conditions, the follicles would produce a single egg with each monthly cycle, but with the addition of fertility drugs, several follicles are stimulated to mature. The success rate of the GIFT procedure is higher when several eggs are used, although the rate of multiple pregnancies is also increased.
When the eggs are mature, the doctor harvests them from the woman's ovaries using a needle aspiration procedure that does not require surgery. Once the eggs are harvested, the next phase of the procedure can begin.
Placing the Eggs in the Fallopian Tubes
A few hours before the eggs are harvested, a sperm sample is gathered from the man involved in the procedure. Once the eggs have been removed, they are combined with the sperm in a catheter. This catheter is then used to place the combined eggs and sperm directly into the woman's fallopian tube using a laparascope. Placing the eggs and sperm in the fallopian tube requires a small incision to insert the catheter.
The major difference between GIFT and IVF occurs in this stage, since in IVF the eggs and sperm are combined in a petri dish and fertilization takes place there. After fertilization, specific fertilized eggs are chosen and placed inside the uterus. In GIFT, however, fertilization actually takes place within the fallopian tubes, as it would during normal conception.
Because fertilization takes place inside the woman's body, there is no need to preserve or dispose of additional fertilized eggs, as is often the case with IVF. This leads some people to feel more comfortable with ethical concerns surrounding all forms of Assisted Reproductive Technology (ART), since there is no culling or long-term storage of already fertilized eggs.
Zygote Intrafallopian Transfer
A similar procedure to GIFT is Zygote Intrafallopian Transfer, or ZIFT, in which fertilized eggs are placed in the fallopian tube, rather than simply a mixture of sperm and eggs. In ZIFT, eggs are fertilized under laboratory conditions, much as with IVF. This reintroduces the ethical concerns regarding culling or storage of fertilized eggs, but does increase the success rate in many cases.
Success rates for GIFT are similar to those for IVF, but patients who have damaged fallopian tubes, blockage in the tubes, or certain types of damage to the uterus are not considered good candidates for the procedure and should consult with a fertility specialist regarding other forms of ART.
