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PubMed1989

Alternatives to IVF: the outcome of 1071 first GIFT procedures.

Gamete intra-Fallopian transfer (GIFT) is the most important treatment method for infertile couples that has been developed since in-vitro fertilization and embryo transfer (IVF/ET) became available. Analysis of the data of 1071 first GIFT procedures is presented and the predominant factors affecting success are discussed. An overall pregnancy rate of 33.6% was achieved in this group of patients who were unselected in relation to age, number of oocytes transferred, quality of sperm and response to ovulation induction. The success of GIFT is dependent upon the number and quality of oocytes transferred and upon the quality of the sperm. Pregnancy occurred in 21.4% of patients receiving up to four oocytes compared with 40.3% in whom five or more were transferred. Multiple pregnancy rates however were 17.3% in the first group and 32.3% in the second group. Age is a major factor influencing the chances of success with patients less than 30 years of age achieving a 40.2% pregnancy rate reducing to 19.2% in the over 40 group. Conversely the spontaneous abortion rate increased from 23.4% in the under 30 group to 48.6% in those over 40 years of age. No pregnancies were achieved when sperm motility was less than 20% in the original specimen, whereas pregnancy rates of up to 20% resulted when sperm density was below 10 million. The overall results of this study show comparable success rates for different causes of infertility and that there is a definite association between the outcome of treatment and the number and quality of gametes transferred. A philosophy of flexibility in the treatment of infertile couples is advocated.

Abortion, Spontaneous↗
PubMed1988

Ultrasound-guided fallopian tube catheterization per vaginum: a feasibility study with the use of laparoscopic control.

The fallopian tube can be cannulated per vaginum under ultrasound control. The sensation and ultrasound appearance of smooth passage without visible kinking are accurate predictors of success. The average time taken for each cannulation was 7.2 minutes. Adequate practice in non treatment cycles is essential before proceeding to cell transfer, while further modification of the catheters used may improve overall success.

Adult↗
PubMed1990

One-hundred-and-six gamete intra-fallopian transfer procedures with donor semen.

A single attempt of gamete intra-Fallopian transfer was performed in 106 patients, who had previously failed to become pregnant after a certain number of artificial donor inseminations. A maximum of six unselected oocytes were transferred into the tubes. Fifty-five clinical pregnancies (51.9%) were obtained. There were 11 multiple pregnancies (20%) and 10 miscarriages (18.1%). Only one ectopic pregnancy occurred (1.8%). The age of the patients and the previous number of failed inseminations did not have any significant influence on the outcome of the procedure, whereas the number of transferred oocytes had a proportional, significant correlation with the pregnancy rate.

Adult↗
PubMed1994

[Results of 35 ambulatory gamete transfers: evaluation of a successful method using regional anesthesia].

Thirty-five ambulatory gamete transfers were performed in 29 patients, resulting in a pregnancy rate of 40% and a take-home baby rate of 26%. Upon request 10 transfers in 9 patients were done under epidural anesthesia. The avoidance of general anesthesia allows the patient to consciously participate in her treatment and improves postoperative recovery. Our results suggest that gamete transfer procedures can be carried out under epidural anesthesia with no adverse effects on the pregnancy rate.

Anesthesia, Epidural↗
PubMed1990

Establishment of pregnancies in humans after transcervical transfer of gametes immediately after oocyte retrieval.

This study, like that of Veersema et al. demonstrates the feasibility of direct intrauterine transfer of gametes in initiating pregnancy. Whether the success of this procedure can be further improved with modification (preincubation, in vitro insemination) remains the subject of continued investigation. Notwithstanding this uncertainty, we feel that transcervical transfer of gametes may be an alternative to IVF for patients with ethical concerns regarding IVF.

Cervix Uteri↗
PubMed2001

Embryo development rates after transfer of oocytes matured in vivo, in vitro, or within oviducts of mares.

Objectives of the present study were to use oocyte transfer: 1) to compare the developmental ability of oocytes collected from ovaries of live mares with those collected from slaughterhouse ovaries; and 2) to compare the viability of oocytes matured in vivo, in vitro, or within the oviduct. Oocytes were collected by transvaginal, ultrasound-guided follicular aspiration (TVA) from live mares or from slicing slaughterhouse ovaries. Four groups of oocytes were transferred into the oviducts of recipients that were inseminated: 1) oocytes matured in vivo and collected by TVA from preovulatory follicles of estrous mares 32 to 36 h after administration of hCG; 2) immature oocytes collected from diestrous mares between 5 and 10 d after aspiration/ovulation by TVA and matured in vitro for 36 to 38 h; 3) immature oocytes collected from diestrous mares between 5 and 10 d after aspiration/ovulation by TVA and transferred into a recipient's oviduct <1 h after collection; and 4) im mature oocytes collected from slaughterhouse ovaries containing a corpus luteum and matured in vitro for 36 to 38 hours. Embryo development rates were higher (P < 0.001) for oocytes matured in vivo (82%) than for oocytes matured in vitro (9%) or within the oviduct (0%). However, neither the method of maturation nor the source of oocytes affected (P > 0.1) embryo development rates after the transfer of immature oocytes.

Animals↗
PubMed1994

The contribution of embryo cryopreservation to in-vitro fertilization/gamete intra-fallopian transfer: 8 years experience.

In this paper, the authors summarized their experience with embryo cryopreservation over an 8-year period. The results, therefore, reflect the long-term benefit of embryo cryopreservation to the overall in-vitro fertilization/gamete intra-Fallopian transfer (IVF/GIFT) programme and to the women who had embryos cryopreserved. The stable survival rate of thawed embryos and pregnancy rate, especially over the past 4 years, suggests that the results can reliably be used to evaluate the efficacy of the embryo cryopreservation programme. The ongoing pregnancy rate of frozen/thawed embryo transfer is 10.9%, comparable with the ongoing pregnancy rate of fresh IVF/embryo transfer in our unit over the same period. In addition to those factors known to affect the pregnancy rate in fresh IVF/GIFT cycles, such as age of the recipients and number of embryos transferred, the major factor affecting the efficacy of the cryopreservation programme is the number of oocytes retrieved in the initial stimulation cycle, and the number of embryos available for cryopreservation. The storage time of cryopreserved embryos will also have a significant effect on the realization of the total potential of embryo cryopreservation. Overall the contribution of cryopreservation to our IVF/GIFT programme is substantial, increasing pregnancy rate by 4%, while the greater net benefit, of course, is for the women who had embryos cryopreserved (pregnancy rate increased by 7%), especially for those who returned for frozen/thawed embryo transfer cycles (pregnancy rate increased by 11%).

Adult↗
PubMed1991

[Pregnancy after transfer of the gametes into the fallopian tubes].

Three patients with idiopathic sterility were treated by transferring the gametes into uterine tubes. Clomiphene+ citrate stimulation of superovulation was employed. Preovulatory oocytes were obtained via the laparoscopic approach. Two oocytes with capacitated spermatozoa were placed into the tube of patient 1, four cells into one tube of the second patient, and two cells into each tube of the third patient. Pregnancy started in two cases, uterine in one, eventuating in 12-13 weeks in spontaneous abortion, and tubal in the other, eventuating in tubectomy. These data evidence the possibility of transferring gametes into uterine tubes to sterile patients, in whom sterility is not caused bu tubal diseases.

Adult↗
PubMed1990

[Retrograde zygote intrafallopian transfer in the treatment of unexplained infertility].

The first Scandinavian pregnancy after retrograde zygote intrafallopian transfer is reported. The individual stages in the treatment are described. These consist of hyperstimulation, oocyte aspiration and fertilising of the oocytes and, finally, transfer through the cervix and uterus and retrogradely to the salpinx under ultrasonic guidance. Zygote intrafallopian transfer (ZIFT) is suitable only for couples with unexplained infertility in contrast to in vitro fertilisation (IVF) which is employed in cases in which the fallopian tubes have been removed or do not function in the female partner. The principles and the expenses involved are, by and large, similar for ZIFT and IVF.

Adult↗
PubMed1990

Luteinization to oocyte retrieval delay in women in whom multiple follicular growth was induced as part of an in vitro fertilization/gamete intrafallopian transfer program.

Different luteinization-to-oocyte-retrieval delays were examined in 64 IVF/GIFT patients. Multiple follicular stimulation was induced with combined therapy of hMG and GnRH-a to create continuous pituitary suppression and thus eliminate endogenous gonadotropin fluctuations. The results demonstrated that with this induction regime, the time interval can be extended to 39 hours without preoperative ovulation and with improved oocyte maturity.

Buserelin↗
PubMed1996

Transfer of gametes into the fallopian tubes--is choice of side important?

The aim of this study was to define pregnancy rates for gamete intra-Fallopian transfer (GIFT) with respect to the ovary from which most oocytes were collected (i.e. a gross index of ovarian stimulation) and the Fallopian tube (ipsilateral or contralateral) into which gametes were replaced. The only inclusion criterion was the ability to transfer gametes into the Fallopian tubes at GIFT. No other factors that could influence outcome were considered. In this retrospective review of the clinic's database, no relationship was found between pregnancy rate and placement of gametes into the Fallopian tube coincident with the ovary from which most oocytes were collected. Thus when performing unilateral tubal transfer at GIFT gametes may be returned to the side most convenient to the operating surgeon without fear of compromising pregnancy potential.

Adult↗
PubMed1989

Surrogate human fallopian tubes for overcoming tubal infertility.

A procedure has been devised in order to establish a pregnancy in a patient with severe, untreatable tubal infertility who had unsuccessfully undergone tubal reconstructive surgery and repeated in-vitro fertilization procedures. This technique, which involves a volunteer, fertile woman, results from the combination of two infertility treatments: namely gamete intra-Fallopian transfer and uterine flushing. The gametes of the infertile couple were introduced into the distal tube of a synchronized volunteer woman; after 5 days, the embryos, recovered by lavage of the volunteer's uterus, were transferred into the patient's uterus with a resulting pregnancy and delivery.

Adult↗
PubMed1993

Combined intra-uterine and extra-uterine pregnancy in the contralateral tube after gamete intra-fallopian transfer.

A case of combined intra-uterine and contralateral tubal pregnancy after gamete intra-Fallopian transfer (GIFT) is presented. Laparotomy with partial tubal resection was performed after tubal rupture. The intra-uterine pregnancy is still ongoing without complications. Heterotopic pregnancies are dangerous conditions for the patient and should be taken into account after transfer of multiple oocytes. To our knowledge this is the first report of a heterotopic pregnancy in the contralateral tube after GIFT.

Adult↗
PubMed1995

In vitro retrieval of epididymal sperm: a new approach to achievement of pregnancy for post-testicular azoospermia.

OBJECTIVE: To determine the efficacy of in vitro retrieval of epididymal sperm for pregnancy induction for obstructive azoospermia patients. DESIGN: Patients were divided into three groups as follows: [1] ductal obstruction with previous epivasostomy (group I); [2] ductal obstruction with previous epididymitis (group II); and [3] ductal obstruction without previous epivasostomy or epididymitis (group III). SETTING: A university teaching hospital. PATIENTS: Twenty infertile males with obstructive azoospermia. INTERVENTIONS: Epididymides were detached surgically just after harvest of oocytes from corresponding wives and severed into three pieces (caput, corpus, and cauda). Each piece was dissected and squeezed in Ham's F-10 medium to retrieve the sperm. After completion of sperm preparation, IVF of their wives' oocytes and zygote intrafallopian transfer followed. RESULTS: Overall pregnancy rate by in vitro retrieval of epididymal sperm was 35% (7 of 20). The rate for group I was 0%, or 0 of 6; for group II the rate was 0%, or 0 of 3; and for group III it was 63.6%, or 7 of 11. CONCLUSIONS: In vitro retrieval of epididymal sperm can be a new method for inducing pregnancy in surgically incorrectable obstructive azoospermia.

Epididymis↗
PubMed1991

Pregnancy following gamete intra-fallopian transfer (GIFT) with cryopreserved semen from infertile men following therapy to lymphomas or testicular tumour: report of three cases.

Cryopreserved spermatozoa from men having treatment for lymphoma or testicular tumour have been reported to function sub-optimally. We report on three successful pregnancies following gamete intra-Fallopian transfer (GIFT) using such cryopreserved sperm samples. In one case, ovum donation was required since the woman had premature ovarian failure.

Adult↗