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PubMed1995

Success rates with gamete intrafallopian transfer and in vitro fertilization in women of advanced maternal age.

OBJECTIVE: To evaluate the effect of maternal age on outcomes for IVF and GIFT in women 40 to 45 years of age. DESIGN: Retrospective. SETTING: Boston IVF, a free-standing university-affiliated IVF and GIFT unit. PATIENTS: A total of 2,931 cycles of IVF and 1,826 cycles of GIFT were analyzed in women undergoing assisted reproductive technologies (IVF or GIFT) using autologous eggs. INTERVENTIONS: Medical records of patient outcomes were reviewed. RESULTS: For patients undergoing IVF, the cancellation rate for initiated cycles showed significant differences in women aged 25 to 39 (38.3%), women aged 40 to 43 (49.5%), and women aged 44 to 45 years (69.5%). A significantly lower delivery rate per stimulation and delivery rate per retrieval was found in women aged 40 to 43 years when compared with women aged 25 to 39 years. No deliveries occurred in 59 cycles in women aged 44 to 45 years, thereby representing a significant difference when compared with both women aged 25 to 39 years and women aged 40 to 43 years. For patients undergoing GIFT, the cancellation rate for initiated cycles was significantly higher in women aged 40 to 43 (25.0%) and 44 to 45 years (31.0%) when compared with women aged 25 to 39 years (15.1%). A significantly lower delivery rate per stimulation and delivery rate per retrieval was found in women aged 40 to 43 and 44 to 45 years when compared with women aged 25 to 39 years. CONCLUSIONS: Success rates for IVF and GIFT decline significantly in women > 40 years old. Women aged > or = 44 years are unlikely to benefit from the use of IVF and GIFT.

Adult↗
PubMed1989

[GnRH agonist/hMG stimulation in gamete intrafallopian transfer (GIFT)].

During a period of 17 months 61 couples without pathological tubal factors were treated by follicular puncture and gamete intra-Fallopian transfer (GIFT) at the department of Obstretrics and Gynaecology, University of Hamburg. The combination GnRH-antagonist (GnRH-A)/hMG was administered in 69 stimulation cycles. Two different GnRH-A application forms were used (daily intranasal spray/monthly depot injection). In all cases mature oocytes were collected after ovulation induction, and gamete transfer was performed. None of the cycles had to be cancelled. Twenty-two clinical pregnancies were achieved (32% by stimulation cycle). The highest pregnancy rate was observed in the group of cervical infertility (58%), lowest rate in cases of pathological male factors (15%). In addition, pregnancy rate correlated with the number and maturity of transfered oocytes. The combined GnRH-A/hMG stimulation therapy allows for a prolonged active follicular development without the occurrence of endogenous, premature luteinization. Besides a more flexible and effective strategy of ovarian stimulation, the number of follicles/oocytes was L, increased which provided a better condition for GIFT.

Administration, Intranasal↗
PubMed1989

Unilateral gamete intrafallopian transfer: the preferred method?

Pregnancy occurred in 8 of 14 patients with the unilateral transfer of three or four oocytes at GIFT procedures. These results suggest that unilateral GIFT may be at least as successful as the bilateral approach. It would appear that unilateral GIFT rather than in vitro fertilization should be used for patients with one normal fallopian tube, and if the pregnancy rates with unilateral GIFT are substantiated, then this would be preferable to the bilateral approach, as operating time is shorter and there is less risk of trauma to the fallopian tubes at the time of gamete transfer.

Female↗
PubMed1992

Contralateral tubal pregnancy after gamete intrafallopian transfer.

A case of EP after GIFT into the contralateral tube is presented. Hydrotubation with Earle's medium immediately before the GIFT cannot be excluded as a possible cause of gamete migration. The complete demise of the CL also demonstrates that trophoblast can implant and develop without steroidal support.

Adult↗
PubMed1993

Transvaginal versus laparoscopic gamete intrafallopian transfer: a case-controlled retrospective comparison.

OBJECTIVE: To compare pregnancy rates (PRs) obtained by transvaginal ultrasound (US)-guided GIFT with PRs from conventional laparoscopy-based GIFT. DESIGN: Retrospective case-controlled study. SETTING: Large, private assisted conception service. PATIENTS: Twenty consecutive cycles of transvaginal GIFT, each matched with three cycles of laparoscopic GIFT on the basis of patient age, number of previous unsuccessful attempts at GIFT, number of eggs transferred, and total number of eggs obtained. MAIN OUTCOME MEASURE: Probability of clinical pregnancy. RESULTS: The PR from transvaginal GIFT was 20.0% (95% confidence limits 13% to 27%), compared with a PR from laparoscopic GIFT of 35.0% (23% to 50%). CONCLUSION: Transvaginal GIFT with present techniques seems to be less effective than laparoscopic GIFT, but it can be considered as a practical alternative to ovarian stimulation and intrauterine insemination and to peritoneal ovum-sperm transfer.

Adult↗
PubMed1996

Incongruent follicular development reduces gamete intrafallopian transfer pregnancy rate.

OBJECTIVE: To test the null hypothesis that asymmetric or incongruent follicular development does not influence GIFT pregnancy rates (PRs). DESIGN: A prospective comparative study. SETTING: Tertiary referral center for infertility. PATIENT(S): Ninety-three consecutive infertile patients having GIFT. INTERVENTION(S): Controlled ovarian hyperstimulation and GIFT. MAIN OUTCOME MEASURE(S): The incongruity ratio as a parameter of the asymmetry in follicular development and the clinical PR. RESULT(S): An inverse relationship was observed between the degree of incongruity and the clinical PRs. In patients with an incongruity ratio < 1.5, the clinical PR was 56.1%. In patients with an incongruity ratio > or = 1.5, the clinical PR was only 17.3%. CONCLUSION(S): Incongruent follicular development during controlled ovarian hyperstimulation has a marked negative influence on the outcome of GIFT cycles. Factors such as side of the gamete transfer and oocyte quality did not account for the observed differences.

Adult↗
PubMed1991

Selective reduction after gamete intrafallopian transfer.

Selective reduction was performed in a patient with triplet pregnancy in the 9th week of gestation. Selective reduction of the fetuses to two was performed by puncture using vaginal ultrasound probe. No complications occurred and the patient was delivered of healthy twins.

Abortion, Induced↗
PubMed1996

Gamete intrafallopian transfer.

GIFT involves placement of a donor's oocyte into a surrogate's oviduct. Fertilization and embryo development occur within the recipient's reproductive tract. GIFT provides a viable method to obtain pregnancies from subfertile mares for which embryo transfer has been nonproductive. Currently, pregnancy rates after GIFT have been variable, although high success rates have been reported recently. Further refinement of techniques should allow GIFT to be used in research and commercial programs.

Animals↗