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Eeyore

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Thursday, May 10th 2007, 10:04am

INFO: A ROUGH GUIDE TO GIFT

For couples having difficulty getting pregnant, one infertility treatment that can help treat a variety of infertility problems, including both female infertility and male infertility, is gamete intrafallopian transfer (GIFT). GIFT is a type of assisted reproductive technology (ART) procedure that can help couples achieve their goal of pregnancy more quickly. But what exactly is GIFT and what is the average pregnancy success rate associated with this type of ART procedure?


What is GIFT?
First introduced in 1984, gamete intrafallopian transfer is an assisted reproductive technology treatment in which the eggs are removed from the ovaries and are combined with washed sperm. The eggs and sperm are then placed in the fallopian tubes via a small incision in the abdomen that is created using a laparoscopy.

Here is an overview of the GIFT process:

• eggs are stimulated using medication
• eggs are collected in a process referred to as aspiration
• three to four eggs are combined with 200 000 sperm in a catheter
• combined egg and sperm are transferred into the fallopian tubes using a laparoscopy
• Because the eggs and sperm are directly placed in the ampullary region of the fallopian tubes, fertilisation and early embryo development occur in a natural environment. The embryo is also transported to and enters the uterine cavity naturally. This is in contrast to IVF, in which fertilisation occurs in the lab.

How It Works

Similar to IVF, women undergoing GIFT begin by taking medication to stimulate the maturation of their egg follicles. Before the eggs are naturally released, your doctor retrieves them using the same method as in IVF. Next, your eggs, along with a semen sample provided by your partner, are immediately placed in a tube. Through laparoscopy, a type of surgery that involves making a small incision just below your navel to insert a tube, the eggs and sperm are then placed in your fallopian tube. The entire procedure, from egg retrieval to egg and sperm transfer, is done under anesthetic.

Once the eggs and sperm have been transferred to your fallopian tube, fertilization is allowed to happen naturally. If any eggs are fertilized, they will then travel down your fallopian tube to your uterus for implantation. Usually, about four eggs are transferred back to the fallopian tube. The entire process, from beginning the follicle stimulating drugs to transfer of the eggs and sperm, can take between four and six weeks. Two weeks after the transfer has been done, women can take a pregnancy test to see if the procedure was successful.


What Fertility Problems Does GIFT Best Treat?
GIFT is a good option for individuals with non-tubal causes of infertility.

It is also particularly beneficial in cases in which a couple has been trying to get pregnant for a year or more through sexual intercourse without success. Gamete intrafallopian transfer is also a good option when IVF is not successful.

GIFT requires that a woman have no tubal damage, including tubal blockage, and that she have no anatomical problems with her uterus, such as severe intrauterine adhesions.

While GIFT can also be beneficial in cases when male fertility is the cause of infertility, such as low sperm count, it is not recommended for severe male infertility, including when immunologic infertility is the cause of infertility.

Other examples of when gamete intrafallopian transfer is a good infertility treatment option are cases in which ovulation problems or cervical problems result in infertility.


GIFT Success Rate
On average, the gamete intrafallopian transfer pregnancy success rate is that 35% of all cases result in getting pregnant.

In addition, 27% of all cases result in a live birth.


The Cost of Gamete Intrafallopian Transfer
On average, the cost of a GIFT cycle is £5500.

However, this cost varies according to the fertility clinic, and can also fluctuate due to supplementary costs, such as the cost of ultrasound monitoring and medication.


The Advantages of GIFT
One advantage of GIFT is that fertilisation occurs in the body naturally.

In addition, unlike as was previously thought, GIFT does not increase the risk of ovarian cancer.


The Disadvantages of GIFT
Some of the disadvantages of GIFT include that it is a more invasive assisted reproductive technology when compared to in vitro fertilisation. Couples with serious fertility problems who undergo GIFT tend to be more successful in getting pregnant than if they undergo IVF.

In addition, because several eggs are transferred into the fallopian tubes, GIFT is associated with an increased risk of multiple births. In turn, multiple births are associated with a variety of pregnancy complications, including low birth weight and birth defects.

Eeyore

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Thursday, May 10th 2007, 10:32am

INFO: A ROUGH GUIDE TO GIFT/ZIFT

One type of assisted reproductive technology (ART) that individuals are also turning to when fertility problems are causing difficulty in getting pregnant is zygote intrafallopian transfer (ZIFT). ZIFT is a type of ART procedure that can be used to treat a variety of fertility problems, including female infertility and male infertility. But what exactly is ZIFT and what does this ART procedure involve? What are some of the benefits and risks associated with ZIFT and what is the cost of this infertility treatment?


What is ZIFT?
Zygote intrafallopian transfer (ZIFT) is an assisted reproduction procedure that is very similar in nature to gamete intrafallopian transfer (GIFT). ZIFT represents less than one percent of all ART methods.

In ZIFT, a woman is given fertility drugs near the beginning of her menstrual cycle in order to stimulate the onset of ovulation. This produces several mature eggs for fertilisation as opposed to the usual single mature egg that is produced during a woman’s monthly cycle. In some cases, a woman is given synthetic hormones in order to stimulate ovulation.

A visit to the doctor will ensure that a woman’s eggs are indeed mature; an ultrasound or blood test will be used to check a woman’s hormone levels to ensure that her eggs are indeed mature.

When the eggs are mature, a doctor will administer an anaesthetic and remove the eggs from the ovaries with the insertion of a needle through the vaginal wall. An ultrasound will be used in order to locate the eggs.

The doctor will then combine the mature eggs with the male’s sperm in a dish in a laboratory; the eggs and sperm will be monitored closely for fertilisation.

Approximately one day later, each of the fertilised eggs will have transformed into a developing embryo (zygote) and take on the appearance of a cluster of cells.

Minor surgery will be performed in order to insert between one and four zygotes into the fallopian tubes by creating a small incision in the abdomen. This procedure is performed using a thin tube called a laparoscope. Any zygotes not utilized during the operation can be frozen for future use.

If the procedure is successful, the zygote will travel through the fallopian tube and implant itself along the uterine wall, resulting in pregnancy.

A pregnancy test will be taken two weeks after surgery in order to determine whether pregnancy has occurred.

One cycle of ZIFT will last from between four to six weeks.


Types of Fertility Problems ZIFT Helps to Treat
There are a variety of fertility problems that ZIFT can help treat including both female infertility and male infertility. Such infertility factors include:

• if the fallopian tubes are unblocked and undamaged and other types of ART have been unsuccessful
• ovulation problems
• low sperm count
• However, in cases when the male partner’s sperm count is extremely low, ZIFT is used in conjunction with in vitro fertilisation (IVF).


Pregnancy Success Rates of ZIFT
The rate of pregnancy success associated with zygote intrafallopian transfer depends greatly on a woman’s reproductive health and her age; generally, the younger a woman and the healthier her eggs are, the higher her chance of successfully getting pregnant using ZIFT.

On average, there is a 26% chance of ZIFT resulting in a live birth per cycle.


Risks and Benefits Associated with ZIFT
One of the benefits of ZIFT is that, compared with GIFT, a doctor can confirm whether fertilisation has occurred prior to inserting the eggs into the fallopian tubes. In addition, the embryo travels into the uterus on its own, which means that ZIFT is considered to be a more natural option.

However, 35% of ZIFT pregnancies are multiple pregnancies, which occurs when more than one of the embryo implants itself to the uterine wall. Multiple pregnancies in turn are associated with a higher risk of miscarriage and ectopic pregnancy. Also, ZIFT requires invasive surgery and the costs of fertilising the eggs in a laboratory can be quite high. In addition, many fertility clinics do not offer ZIFT as an alternative fertility treatment.

In some cases, women who must take synthetic hormones in order to stimulate ovulation develop ovarian hyperstimulation (OHSS), a condition that causes bloating, pelvic pain, nausea and dizziness. In rare instances, OHSS can be serious, and may require hospitalization.


The Cost of ZIFT
Zygote intrafallopian transfer is an expensive ART procedure. On average, ZIFT costs between £6 000 and £10 000 per cycle.




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