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Gamete and Zygote Intrafallopian Transfer (GIFT and ZIFT) for Infertility
Some infertile couples are affected by conditions that prevent the sperm and egg from traveling through a fallopian tube, where fertilization and the first stage of cell division take place. The following are assisted reproductive technology (ART) procedures that are rarely used but may improve the chances of conception in the fallopian tubes. The first step of each of these treatment cycles is superovulation, the stimulation of multiple egg production with a series of hormone injections.
Gamete intrafallopian transfer (GIFT) uses multiple eggs collected from the ovaries, which are placed into a thin flexible tube (catheter) along with the sperm to be used. The gametes (both eggs and sperm) are then injected into the fallopian tubes using a surgical procedure called laparoscopy under general anesthesia.
Zygote intrafallopian transfer (ZIFT) combines in vitro fertilization (IVF) and GIFT. Eggs are stimulated and collected using IVF methods, then mixed with sperm in the laboratory. Fertilized eggs (zygotes) are then laparoscopically returned to the fallopian tubes where they will be carried into the uterus. The goal is for the zygote to implant in the uterus and develop into a fetus.
Pronuclear stage tubal transfer (PROST), similar to ZIFT, uses in vitro fertilization but transfers the fertilized egg to the fallopian tube before cell division occurs.
Because of the higher costs and risks related to laparoscopy, and the lesser amount of diagnostic information about embryo development compared with IVF, these procedures are rarely used.
See a picture of the
female reproductive system 
.
The treatment process
- Ovulation and egg retrieval. To prepare for an assisted reproductive procedure using your own eggs, you must get daily injections and be closely monitored for 2 weeks before egg retrieval. At home, you or your partner injects you with gonadotropin or follicle-stimulating hormone (FSH) to stimulate your ovaries to produce multiple eggs (superovulation). After the first week, your doctor checks your blood estrogen levels and uses ultrasound to see whether eggs are maturing in the follicles. During the second week, your dosage may change based on blood tests and other test results. If follicles fully develop, you are given a human chorionic gonadotropin (hCG) injection to stimulate the follicles to mature. The mature eggs are collected 34 to 35 hours later by laparoscopy or needle aspiration guided by ultrasound through the abdomen to the ovaries.
- Sperm collection. Sperm are
collected by means of masturbation or by taking sperm from the
testicle (when there is a blockage that prevents sperm
from being ejaculated or when there is a problem with sperm development).
- For GIFT, the sperm are then placed in a tube (catheter) with the eggs. The catheter is inserted through a small abdominal incision and into a fallopian tube. The eggs and sperm are then injected into the fallopian tube. Usually, two eggs are placed in each fallopian tube.
- For ZIFT, in vitro fertilization is performed. The resulting fertilized eggs (zygotes) are injected into the fallopian tubes in the same way that GIFT is done. The zygotes then travel into the uterus, where it is hoped that they will implant and develop.
| By: | Healthwise Staff | Last Revised: March 19, 2010 |
| Medical Review: | Sarah Marshall, MD - Family Medicine Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology | |
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