Gamete intrafallopian transfer (GIFT) was first developed in 1984 as part of further studies into assisted reproductive technologies (ART). Accounting for less than 1 percent of all ART procedures, GIFT can help you if you have at least one healthy fallopian tube and, for one reason or another (such as religious reasons), prefer for fertilization to happen inside your body as opposed to a laboratory dish (as in traditional IVF).
Many of the steps in a GIFT procedure are similar to traditional IVF procedures, though there are several distinctions.
How GIFT differs from IVF
Like IVF, GIFT involves removing eggs from your ovaries, mixing them with your partner's sperm and returning them to your body. Unlike IVF, after the eggs and sperm (the gamets) are mixed, they are immediately transferred to your fallopian tubes rather than to a laboratory dish.
With GIFT, fertilization happens in your fallopian tubes rather than an incubator. Just as in a natural pregnancy, the fertilized egg(s) moves down your fallopian tubes and develops into an embryo, ultimately implanting into your uterus. Because the eggs are fertilized inside the body, you will not need to discard, donate or store extra embryos.
On the down side, GIFT also means that:
- While your doctor may evaluate and choose the healthiest eggs, she has no way of knowing if the eggs will become fertilized. In IVF, your eggs are placed in the uterus after fertilization has occurred.
- You will have two different surgical procedures: egg retrieval (as in all ART procedures), and then laparoscopic surgery to place the eggs and sperm in to the fallopian tubes.
Your doctor will only attempt GIFT if you have at least one healthy fallopian tube.
Read: Advantages and Disadvantages of GIFT.
How is GIFT performed?
One GIFT cycle takes approximately four to six weeks from start to finish. Prior to GIFT, your doctor will perform tests to confirm your eggs, fallopian tubes and uterus are healthy enough for the procedure. Your doctor may also test sperm quality. This process varies based on your doctor and will include the following steps:
Ovarian stimulation and monitoring
You will take medications to stimulate your ovaries and the ovarian follicles into producing multiple eggs. It takes roughly eight to 14 days of ovarian stimulation for this step, usually depending on how your follicles react to the medications.
During this time, your doctor uses:
- Blood tests to measure your hormone levels for estrogen (typically high before ovulation), and progesterone (typically high after ovulation) to make sure you do not prematurely ovulate.
- Ultrasound tests to make sure your ovarian follicles are developing properly.
Ovulation induction, egg retrieval and sperm collection
When the follicles are ready, your doctor will give you an injection of human chorionic gonadotrophin (hcG), or similar medications that stimulate the final maturation of your eggs.
After ovulation induction, your doctor retrieves your eggs using a technique called aspiration -- by threading an ultra-fine needle attached to a suction device from the vagina all the way to your ovaries to gently catch the eggs. This step takes approximately 30 minutes. As is the case with all ART procedures, timing is essential for egg retrieval.
With IVF, you are given a mild sedative to offset any discomfort, but with GIFT, you may have general anesthesia as you will need it for the laparascopic surgery that will follow.
Prior to ovulation induction, sperm is collected (through masturbation or directly from the testicle) and prepared for fertilization by "washing" away the semen. The sperm is placed in a small catheter with the eggs, so they can be implanted in the fallopian tubes together.
In the final step of the GIFT cycle, your doctor performs a laparoscopic surgery to insert the eggs mixed with sperm into your fallopian tubes. In this surgery, your doctor makes several keyhole incisions in your abdomen, then uses a thin, flexible tube containing a video camera (a laparascope) to guide the catheter containing the eggs and sperm to your fallopian tube.
After the eggs are inserted and the incisions stitched up, the GIFT cycle is complete.
To ensure your potential embryo has the best chance of survival, you will take medications to increase your progesterone levels, so that the walls of your ovaries and uterus thicken, and give your fertilized eggs the best chance of implanting.
Risks associated with GIFT
GIFT carries the same risks of all ART procedures, including hyperstimulation and complications related to the egg retrieval procedure. Additionally, the surgery used in GIFT presents the same risks as any procedure that involves general anesthesia. Minor risks associated with laparoscopy include:
- Postoperative bladder infection
- Skin irritation
- Hematomas (blood-filled bruising) of the abdominal wall
- Pelvic or abdominal infections
Serious complications associated with laparoscopy are rare.
GIFT Success Rates
The success of GIFT depends on multiple factors, including your age, reproductive health and reactions to the procedures. Check with your doctor for the success rates specific to your facility. There aren't any national success rates specific to GIFT. Read about the success rates for ART overall.