Tubal catheterization for intrafallopian insemination and transvaginal gamete (GIFT) or zygote intrafallopian transfer (ZIFT): our experience in a total of 1128 treatment cycles.
OBJECTIVE
Our purpose was to increase the number of fertile spermatozoa at the natural site of fertilization by retrograde tubal insemination (TV-IFI; transvaginal intrafallopian insemination) and also to perform transvaginal GIFT or ZIFT (TV-GIFT or TV-ZIFT) avoiding the laparoscopic procedure, especially in selected high-risk cases.


RESULTS
The method was used in a total of 1128 treatment cycles (948 for TV-IFI and 180 for TV-GIFT or TV-ZIFT). TV-IFI was possible in 882 of the 948 cycles, resulting in 108 clinical pregnancies (12.24%). The remaining 66, due to bilateral tubal catheterization failure (6.9%), underwent intrauterine insemination (IUI) instead. Bilateral TV-IFI gave better results than unilateral, while combination with IUI did not seem to improve the outcome. Of the 180 cycles prepared for TV-GIFT or ZIFT the procedure was completed in 166, resulting in 24 clinical pregnancies (19% per patient and 14.45% per cycle). Due to bilateral tubal catheterization failure (8.2%) in the remaining 14 cycles (9 patients), IVF-ET was employed as an alternative.


CONCLUSIONS
Simple and cost-effective TV-IFI may achieve a reasonable pregnancy rate, justifying its application in cases with previously failed IUI and before entering the IVF program. On the other hand, TV-GIFT or ZIFT, although less effective than the classical laparoscopic approach and IVF-ET, is worth pursuing, considering its safety and the minimal surgical intervention without anesthesia, and especially in selected high-surgical risk and obese patients.
Tzafettas
J
J
Blue Cross IVF and Infertility Centre, Thessaloniki, Greece.
Loufopoulos
A
A
Stephanatos
A
A
Mukherjee
A
A
D000328:Adult; D002404:Catheterization; D005187:Fallopian Tubes; D005260:Female; D015181:Gamete Intrafallopian Transfer / Q000379:methods*; D006801:Humans; D007315:Insemination, Artificial / Q000379:methods*; D010535:Laparoscopy; D016896:Treatment Outcome; D017388:Zygote Intrafallopian Transfer / Q000379:methods*