GIFT A Life
GIFT stands for gamete intrafallopian transfer. A gamete is a male or female sex cell --- a sperm, or an egg. During GIFT, sperm and eggs are mixed and injected into one or both fallopian tubes. After the gametes have been transferred, fertilization can take place in the fallopian tube as it does in natural, unassisted reproduction. Once fertilized, the embryo travels to the uterus by natural processes.
As in IVF, a GIFT treatment cycle begins with ovulation enhancement which is followed by egg harvest, usually by means of laparoscopy. But the similarity to IVF ends here. In IVF, an embryo is transferred. In GIFT, gametes are transferred.
Only patients who have at least one
normal, healthy fallopian tube are candidates for GIFT. Such patients include
women who have unexplained infertility or mild endometriosis and couples
whose infertility results from male, cervical, or immunological factors.
Some doctors recommend that couples with male factor infertility proceed
with GIFT only if it has been proven that the man's sperm can fertilize
the woman's egg either by in vitro fertilization or by past pregnancies.
The Basic Steps of GIFT
The basic steps of GIFT are ovulation
enhancement, egg harvest, insemination, and gamete transfer. The eggs are
usually harvested during laparoscopy. During this same laparoscopy procedure,
which takes about an hour, eggs are mixed with sperm and the gametes are
The harvested eggs are examined under
the microscope and graded for maturity. The selected eggs are placed in
individual dishes and combined with sperm (insemination). The sperm are
prepared in advance in the same manner as for IVF. Some doctors prefer
to wait for about 10 minutes before the transfer, since during this period
the sperm adhere to the zona pellucida of each egg. Many programmes load
eggs and sperm individually into a catheter and inject them into one or
both of the fallopian tubes.
The sperm - egg mixture is loaded
into a specially designed catheter . This is then directed into the fallopian
tube(s) through their fimbrial opening while looking through the laparoscopy.
Up to four eggs and sperm may be injected into one or both tubes. Gametes
will be transferred only if the fallopian tubes appear healthy. If the
surgeon determines that the tubes are unhealthy, IVF should be attempted
instead. For this reason, GIFT should be undertaken only at facilities
that have the capability to perform IVF also.
Specialists generally agree that
pregnancy rates are higher for GIFT than for IVF - in fact, GIFT is about
twice as successful as IVF. In part, this may be due to the type of patient
accepted into GIFT programmes. It may also be because the in vivo tubal
environment is more "physiologic " for the gametes and embryo than the
in vitro environment.
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