Gamete intra-fallopian transfer (GIFT)

GIFT is a method of treatment which has developed from IVF and in the past was used mainly in cases of "unexplained" infertility. However, with the improvement in the results of IVF, GIFT is used very infrequently nowadays. It tends to be reserved for the older patient who has failed to achieve a pregnancy after several attempts at IVF. In the GIFT technique, gametes (eggs and sperm) are transferred together into the fallopian tubes where it is hoped that fertilisation will occur naturally. The embryos that then form will pass along the tubes and enter the uterus at the correct phase of the cycle so that they may implant naturally. GIFT is therefore rather like a dating agency, introducing the sperm and eggs to each other and then allowing Nature to take its course!

The ovaries are stimulated in the same way as for IVF (see IVF information). If follicle development is satisfactory, egg retrieval is carried out 34 - 37 hours after the hCG injection. Egg retrieval is performed by laparoscopy under general anaesthetic in the operating theatre. The sperm preparation method is identical to that used for IVF and IUI. A maximum of three mature eggs (if you are under the age of 40) or four eggs (if you are over 40) are placed together with sperm into one or both fallopian tubes via a fine catheter which is passed directly into the outer end of the tube.

Rather than throw away any unused eggs, it is possible to carry out IVF and freeze any suitable resulting embryos for your own future use.

You should be able to go home the same day. Follow-up treatment is the same as for IVF. If no period occurs, a pregnancy test is carried out 16 days after the GIFT procedure.

The take-home baby rate for GIFT is very similar to that expected for IVF cycles. An essential requirement for GIFT of course, is that the fallopian tubes must be 100% healthy and patent at a preliminary laparoscopy and dye test.

One of the problems with GIFT is that if a GIFT treatment cycle fails, there is no way of telling whether or not fertilisation has even occurred. For this reason, if there has been no history of a previous pregnancy, most cases of 'unexplained' infertility will be treated by IVF so that the ability of the sperm to fertilise the eggs may be confirmed. GIFT and IVF should have very similar success rates but IVF has the advantage of being less invasive. However, there will occasionally be some cases where GIFT is the logical treatment to use.

Very careful counselling is given to both of you before embarking upon a course of GIFT treatment.

March 2009