To whom GIFT is advised and how is GIFT performed?

Gamete Intra-Fallopian Transfer (GIFT) is a procedure in which the eggs are mixed with sperm and the mixture is then injected into the Fallopian tube. It is suitable for women who have at least one healthy Fallopian tube. The aim of GIFT is to allow fertilization to occur in the right place and implantation at the right time.

There are selected groups of patients to whom gamete intra-Fallopian transfer (GIFT) is recommended.• Couples with unexplained infertility.
• Women with minimal endometriosis.
• Men with infertility problem (not severe).
• Couples who have had failed donor insemination.
• Where transcervical embryo transfer is impossible and the patient has one healthy tube.

The procedure is carried out as a day case surgery under a general anaesthetic, and involves making three small cuts in the abdomen. Fertility drugs are used to stimulate the ovaries, monitoring is also carried out as with IVF treatment. Eggs may be collected either by a vaginal ultrasound scan or laparoscopically using a fine needle and gentle suction.
Once the eggs are collected, they are examined under the microscope for quality. The best eggs are then mixed with washed and prepared sperm in a small volume of culture medium. The end of the fallopian tube is grasped gently and a guided fine canula is passed through the fimbrial end of the tube. The mixture of the eggs and sperm is then deposited into the Fallopian tube.
Gamete intra-Fallopian transfer (GIFT) procedures are not regulated by the Human Fertilisation and Embryology Authority (HFEA) in the United Kingdom (provided that no donor eggs or donor sperm are used), so it is up to the clinician to decide how many eggs to transfer. However, in most cases, two or three eggs are usually transferred per cycle. Any spare eggs that are collected may be fertilized in-vitro and the resulting embryos are frozen (if they are of good quality to freeze) for later embryo replacement.
More recently, attempts have been made to simplify the procedure by collecting the eggs by vaginal ultrasound and injecting the egg and sperm mixture into the tube via the cervix using a special catheter. The procedure is usually performed under ultrasound guidance. The reported pregnancy rates with this method are less than that with conventional laparoscopy GIFT.
After the GIFT procedure, the patient is usually given hormonal supplements, in the form of tablets, pessaries, gel or injection to help the implantation of embryos.