Gamete Intrafallopian Transfer (GIFT)

Accounting for just 2 percent of ART procedures performed each year, gamete intrafallopian transfer (GIFT) may not be among the most popular assisted reproductive technology (ART) procedures, but approximately 300 healthy babies are born every year in the United States as a result of GIFT, proving it is a valuable treatment option for hundreds of couples.

GIFT involves removing your eggs, mixing them with your partner's (or donor's) sperm and immediately placing the combination into your fallopian tubes. While this procedure may sound similar to in vitro fertilization (IVF), they have more differences than similarities. In both procedures, the ovaries are stimulated to produce more eggs than usual, and they are put together with sperm in a dish, but the biggest difference between GIFT and IVF is that during GIFT, the gametes (eggs and sperm) are transferred into the fallopian tube so that fertilization may occur inside your body. Rather than begin its development in an artificial environment, which is what occurs in IVF, the embryo is able to grow in natural surroundings. In addition, while IVF provides your physician with the opportunity to select only the best quality embryos for transfer after they have been fertilized, GIFT transfers eggs and sperm immediately into your tubes.

Procedure

In order to stimulate your ovaries to develop several mature eggs and prepare your body for GIFT, your doctor will prescribe a fertility drug that you will start taking near the beginning of your menstrual cycle. Once your eggs are mature, your doctor will do an ultrasound to locate them and you will then be given an anesthetic so that he or she may collect your eggs by inserting a thin, hollow needle through your vaginal wall.

As soon as your doctor collects your eggs (about three or four of them), he or she will combine them with about 200,000 of your partner's sperm in a sterile dish. Immediately after they are combined, the mixture will be transferred to your fallopian tube through a small incision in your abdomen using a very thin tube called a laparoscope. If any eggs are successfully fertilized, they will travel down your fallopian tube and into your uterus for implantation. Approximately two weeks after the transfer, you'll be able to take a pregnancy test to see if the procedure was a success.

Even though you will be under anesthetic, GIFT is considered minor surgery and you'll be able to go home the same day. The entire process, from the time you start taking medication to the transfer of the eggs and sperm, can take anywhere from four to six weeks to complete.

Good candidates for GIFT

GIFT tends to be a promising approach for women who have a chance of getting pregnant through other means but have not been successful, whereas IVF is more appropriate for women with more severe infertility concerns. GIFT may also be an option if you have an ovulatory disorder or cervical problems, but you must have at least one unblocked and functioning fallopian tube to even consider undergoing the procedure. Your partner must also be able to provide a healthy sperm sample, unless you choose to use a donor. However, GIFT may be still able to help you conceive together if your partner has a low sperm count.

GIFT is most commonly chosen by couples who have failed to get pregnant after a year or more of trying and those who have not been successful after at least five cycles of ovarian stimulation with intrauterine insemination. If your fertility problems include tubal blockage, significant tubal damage or an anatomic problem with your uterus, such as severe intrauterine adhesions, GIFT is not the right treatment for you. In general, for these issues as well as couples with male factor infertility, IVF is a better approach.

Advantages

One reason you and your partner may be attracted to GIFT is because it allows for fertilization to occur in natural surroundings. For some couples, it is against their personal or religious beliefs for fertilization to take place outside the body, so they turn to the most natural forms of ART in hopes of conceiving. While there are no medical reasons why natural fertilization is more favorable than assisted fertilization, many couples believe the potential for their baby to develop as naturally as possible to be the biggest advantage of GIFT.

Disadvantages

One disadvantage of GIFT comes from taking fertility drugs, which have been known to cause severe side effects, such as nausea, hot flashes, insomnia and depression, so you will need to be closely monitored by your doctor while you're taking them.

A second disadvantage is the invasive surgery (laparoscopy) that is required in order to harvest and transplant your eggs. Thirdly, because the fertilization process cannot be observed, there is no guarantee that any of the eggs will be fertilized.

Undergoing GIFT also increases your chances of having a multiple pregnancy, which occurs in 35 percent of GIFT pregnancies, because more than one egg is transferred into your fallopian tube. While you may be happy to have more than one baby, the risk of miscarriage and other complications are significantly increased in such cases. There is also a greater risk of ectopic pregnancy associated with all ART procedures, in which case an embryo implants in your fallopian tube or abdominal cavity rather than your uterus.

There is a longer list of disadvantages than advantages of GIFT, but it is up to you and your partner to decide if the possible end result - a baby - is worth it, and it usually is!

Success Rates

Like all ART procedures, GIFT success rates vary depending on your specific fertility issues and your age. Younger women usually have healthier eggs and, therefore, higher success rates. The chances of getting pregnant after one cycle of GIFT are approximately 35 percent, while the chances of carrying a baby to term are approximately 27 percent.

Cost

In the United States, one cycle of GIFT can cost anywhere from $8,000 to $10,000. The price varies depending on where you live, your medications, and the number of cycles you undergo. Oftentimes your insurance company will pay a portion of the cost of the procedure, but if they don't, you will be expected to pay the full amount upfront.