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ZIFT

Zygote intrafallopian transfer, or ZIFT, is the most invasive of all infertility treatments and, as a result, only one percent of couples who use ART (assisted reproductive technology) attempt it. However, it can be an effective option for many couples and results in approximately 280 births each year in the United States.

ZIFT, also known as tubal embryo transfer (TET), begins as IVF (in vitro fertilization) and GIFT (gamete intrafallopian transfer) treatments do, with ovarian stimulation, monitoring, and egg retrieval. However, once the eggs are retrieved, they are combined with sperm in a special medium that contains nutrients similar to those found in the uterus. After fertilization takes place the eggs are evaluated, transferred to another dish, and allowed to grow for one day before two to four zygotes are selected and deposited back in the fallopian tube using a laparoscope. In IVF, the eggs are allowed to develop three to five days after retrieval before being transferred to the uterus. With the GIFT procedure, the gametes (egg and sperm) are immediately transferred to the fallopian tubes, and fertilization takes place there, rather than the laboratory.

ZIFT is considered the most invasive of all fertility treatments because the transfer of the zygote must be done through a laparoscope, which involves a small surgical incision (with IVF, the fertilized eggs are transferred vaginally without any incisions). Although laparoscopy is considered minor surgery, it does add to the complexity, risk, and expense of the process. Transfer of the zygotes may be performed in the office under sedation and local anesthetic, or in short-stay surgery if an epidural or general anesthetic is desired. ZIFT also involves two separate procedures (one to remove the eggs, and then another to transplant them back). ZIFT is also expensive, one cycle (4 to 6 weeks) costs $8,000 to $13,000 and many insurance companies don't pay for infertility treatment.

Because fertilization is confirmed before the eggs are inserted into the fallopian tubes, fewer eggs are usually used thereby lowering the risk of multiple pregnancy. However, in approximately 35 percent of ZIFT pregnancies, more than one embryo implants and multiple babies are born. While twins or triplets (or more) may be considered good news for many couples, the pregnancy is considered high risk and the possibility of miscarriage and preterm labor increase.

Because the zygotes are transferred directly to the fallopian tubes, a candidate for ZIFT must have at least one open and functioning fallopian tube. Other possible candidates include women:

  • Who have ovulation problems
  • Whose partner has a low sperm count
  • Who have been unable to become pregnant after a year of trying
  • Who have had 5 or more failed cycles of IUI (intrauterine insemination)
  • Women who have blocked or severely damaged tubes, and those with uterine abnormalities (such as uterine adhesions or a malformed uterus) are not suitable candidates for ZIFT.

Risks associated with ZIFT are similar to those associated with all types of ART treatments, including an increased possibility of ectopic pregnancy. The fertility drugs used can also cause some women to develop ovarian hyperstimulation syndrome (OHSS), which occurs when you respond too well to the drugs and produce too many eggs, causing your ovaries to swell and begin leaking fluid into your abdominal cavity. Some women also experience shortness of breath, dizziness, pelvic pain, nausea, and vomiting.

According to the 2002 report from the Centers for Disease Control (CDC), ZIFT has a success rate of 26.3 percent (live births per retrieval). However, this figure can vary widely depending on the age of the woman, the couple's specific fertility problem, duration of their infertility, and the number of previous ART attempts.


 

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