title: Gamete intra-Fallopian transfer or in-vitro fertilization after failed ovarian stimulation and intrauterine insemination in unexplained infertility?
abstract: A prospective randomized study was designed to compare gamete intra-Fallopian transfer (GIFT) and in-vitro fertilization (IVF) and embryo transfer in the treatment of couples who have failed to conceive after at least three cycles of ovarian stimulation and intrauterine insemination (IUI). A total of 69 couples with primary unexplained infertility of at least 2 years' duration plus at least three failed cycles of ovarian stimulation and IUI were randomly allocated to either GIFT or IVF/embryo transfer. The clinical pregnancy rate was 34% after GIFT treatment and 50% after IVF/embryo transfer. This difference was not statistically significant. The twin rate in the IVF/embryo transfer group was higher than in the GIFT group (53 versus 17%, P = 0.005). We conclude that patients with unexplained infertility and failed ovarian stimulation and IUI can still achieve encouraging pregnancy rates with IVF/embryo transfer or GIFT. Since IVF/embryo transfer is the least invasive of the two procedures and may yield diagnostic information, we would favour this therapy; however, the number of embryos transferred should be reduced to two to reduce the risk of twin pregnancy.
authors.affiliation: Assisted Conception Unit, University College Hospital, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Ranieri
authors.forename: V A
authors.initials: VA
authors.lastname: Beckett
authors.forename: S
authors.initials: S
authors.lastname: Marchant
authors.forename: A
authors.initials: A
authors.lastname: Kinis
authors.forename: P
authors.initials: P
authors.lastname: Serhal
mesh_terms: D000328:Adult; D002064:Buserelin / Q000627:therapeutic use*; D006063:Chorionic Gonadotropin / Q000627:therapeutic use*; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D015181:Gamete Intrafallopian Transfer; D006801:Humans; D007317:Insemination, Artificial, Homologous; D008297:Male; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011446:Prospective Studies; D012099:Reproductive Techniques; D012307:Risk Factors; D016896:Treatment Outcome; D014427:Twins; D014599:Uterus
chemical_list: D006063:Chorionic Gonadotropin; D002064:Buserelin