Gamete intrafallopian transfer (GIFT): use of minilaparotomy and an individualized regimen of induction of follicular development.
The performance of the gamete intrafallopian transfer (GIFT) technique, utilizing an individualized regimen of follicular induction and minilaparotomy in 45 patients with infertility of varying etiologies is reported. The induction regimen consisted of the administration of clomiphene citrate, 100 mg, from day 3 to day 7, and 150 IU FSH/LH (human menopausal gonadotropin [hMG]) from day 6 on. Human chorionic gonadotropin (hCG; 10,000 IU) was administered when at least two follicles measured 16 mm or more in diameter and when serum estradiol (E2) measurement revealed levels of 350 pg/ml per each main follicle. Up to two oocytes and 100,000 motile sperm were transferred to the fallopian tubes via the fimbria, using a catheter. Of the 45 cases, 13 became pregnant by clinical criteria (29 per cent). Of these 13 pregnancies, nine continued to term (69 per cent), three miscarried spontaneously (12 per cent) and one was an ectopic (7 per cent). Of the nine pregnancies that continued to term, five (55 per cent) were twins. Details of the GIFT procedure as well the preliminary non-human primate research studies that led to the development of the GIFT technique are discussed. It is concluded that GIFT is an excellent alternative to in vitro fertilization and embryo transfer (IVF; ET) in all cases of infertility that failed to conceive using conventional forms of therapy and in which the female partner presents at least one normal fallopian tube.
D000818:Animals; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D002996:Clomiphene / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007315:Insemination, Artificial / Q000379:methods*; D007813:Laparotomy / Q000379:methods; D008253:Macaca mulatta; D008297:Male; D008596:Menotropins / Q000008:administration & dosage; D006080:Ovarian Follicle / Q000187:drug effects; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D012661:Semen / Q000382:microbiology; D013396:Suction
D006063:Chorionic Gonadotropin; D002996:Clomiphene; D008596:Menotropins