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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 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 transferred.
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 programs 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.
© Dr. Aniruddha Malpani and Dr. Anjali Malpani www.drmalpani.com
Credits: How to Have a Baby: Overcoming Infertility
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