Gamete intrafallopian transfer in the treatment of infertility: the first series at the University of Palermo (original) (raw)
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Asia-Oceania Journal of Obstetrics and Gynaecology, 1989
Gamete intrafallopian transfer (GIFT) is increasingly accepted as a realistic alternative to i pr wityo fertilization (IVF), or intrauterine insemination (IUI) for treatment of non-tuba1 infertility. The lack of information on fertilization capacity of the gametes, the greater cost relative to IUI, and the partly unsubstantiated claims of higher success rates, caused us some concern with the readiness with which GIFT had been accepted as a standard infertility treatment. So we undertook a provisional GIFT programme with these considerations in mind, and we report on the first 91 GIFT cycles performed in our clinic. Sixty of the patients (62 cycles) treated suffered from idiopathic infertility, 12 from minimal endometriosis, 9 from male factor infertility, and 8 from ovulatory dysfunction. An initial clinical pregnancy rate of 41 % (38/91) was achieved; pregnancy loss was 23% (9/38), giving a continuing pregnancy rate of 32% (29191). Given this undeniably encouraging result, and the potential for diagnostic IVF, embryo freezing, and ovum donation with surplus oocytes collected from this GIFT programme, we now have adopted GIFT permanenay as a treatment to complement our IVF and IUI programmes.
BJOG: An International Journal of Obstetrics and Gynaecology, 1991
Objective-To compare GIFT, intrauterine insemination (IUI) with, and without, ovarian hyperstimulation in the treatment of unexplained infertility. Design-Women randomly allocated to one of three treatment protocols. Setting-Northern Regional Fertility Centre. Subjects-59 couples with unexplained infertility of more than 3 years duration. Interventions-Three cycles of either GIFT, IUI after ovarian hyperstimulation or IUI in a spontaneous cycle. Main outcome measures-Pregnancy resulting in a live birth. Results-Fecundabilities were 0.12 after GIFT, 0.018 after ovarian hyperstimulation and IUI, and 0.018 after IUI in a spontaneous cycle. The fecundability after IUI was no different from that which would be expected without treatment in these couples but fecundability was significantly better (F30.02) after GIFT. Conclusions-This trial does not support the use of IUI in the treatment of unexplained infertility but confirms the value of GIFT. Gamete intrafallopian transfer (GIFT) was first described by Asch et al. (1985) and is now increasingly recommended as the treatment of choicc for unexplained infertility with overall pregnancy rates of 19% (Fourth Report of Voluntary Licensing Authority 1989). However, uncontrolled reports of intrauterine insemination (IUI) after ovarian hyperstimulation suggested that this simpler treatment may have similar success rates (
The treatment of normospermic infertility by gamete intrafallopian transfer (GIFT)
BJOG: An International Journal of Obstetrics and Gynaecology, 1988
Gamete intrafallopian transfer (GIFT) was applied in 207 treatment cycles in 73 couples. T h e pregnancy rate in cycles with only one (2/21? 9.5%) or two (2129, 6.9%) oocytes transferred was significantly less than that in which four oocytes (36/116, 31.0%) were rcplaccd. The collection of more than four oocytes did not influence the pregnancy rate in that treatment cycle. T h e overall pregnancy rate was 24.2% (50 of 207) a n d was similar in the four infertility groups studied (non-occlusive tuba1 disorders, endometriosis, cervical factor and unexplained infertility) with 28 (56%) of the pregnancies delivered at 2 2 0 weeks. T h e pregnancy wastage included 4 (8%) ectopic pregnancies and 3 (6%) late pregnancy losses. The 12 multiple pregnancies occurred following t h e transfer of three and four oocytes. Many therapeutic techniques are now available for the treatment of infertile couples in which thc female partner has patent fallopian tubes. Those procedures involving the manipulation of gametes include artificial insemination with husband's spermatozoa (AIH) whereby spermatozoa are deposited in the cervical canal or uterus (Allen et af. 1985), the placing of oocytes and spermatozoa into the uterus to allow fertilization to occur in vivo (Craft rt al. 1982), and conventional in-vitro fertilization and embryo transfer (IVF-ET) in which fertilization occurs extracorporeally with subsequent transfer of
The role of laparoscopy in the management of infertility
Journal of Obstetrics & Gynaecology, 2014
The advancement of new perspectives in assisted reproductive technology (ART) through the use of modern infertility evaluation techniques has led clinicians to reassess how infertility should best be treated. The usefulness of laparoscopy in the diagnostic work-up of infertile patients or in patients who are unresponsive to fertility treatments is debatable. The purpose of this review is to defi ne the role of laparoscopy in the management of infertility, which is one of the most controversial aspects of reproductive medicine. To the best of our knowledge, laparoscopy is currently not a routine step in the evaluation of infertile women; every patient and clinical condition must be assessed individually. In this review, we investigated the eff ectiveness and the utility of laparoscopy as a diagnostic and therapeutic tool in the management of infertility. Various topics and parameters in ART will be discussed based on the evidence that is currently available.
Human Reproduction, 1999
We have defined fertiloscopy as the combination in one investigation of transvaginal hydropelviscopy, dye-test, optional salpingoscopy, and hysteroscopy, performed on an outpatient basis under local anaesthesia or neuroleptanalgesia. We have applied this approach in a routine manner to 160 infertile patients with no obvious pathology. Fertiloscopy was achieved in 154 patients (96.2%). In five patients visualization was not satisfactory because of technical problem or adhesions in the pouch of Douglas. We had one (0.6%) rectal injury, which was treated conservatively. Sixty patients (37.5%) had normal fertiloscopic examination. Endometriosis was discovered in 21 patients (13.1%) post-pelvic inflammatory disease (PID) lesions in 58 cases (36.2%), and subtle abnormalities in 15 cases (9.3%). Salpingoscopy was completed when post-PID lesions were encountered. In 39% of cases only partial examination was possible because of external tubal adhesions, but it was nevertheless sufficient to obtain a good view of the first one-third of the ampulla. In all, 74 patients (46.2%) were referred directly to in-vitro fertilization (IVF) procedures, and so avoided a further laparoscopy. Quality of imaging, accuracy of the pelvic examination in a physiological manner, and safety of the procedure are the main advantages of this minimally invasive technique. Selection of the patients for surgery is therefore enhanced, and indication for IVF is better balanced, avoiding the performance of extensive procedures in patients who should thus benefit from this less traumatic alternative.
Is GIFT (gamete intrafallopian transfer) the best treatment for unexplained infertility?
BJOG: An International Journal of Obstetrics and Gynaecology, 1992
Objective-To compare the cumulative pregnancy rates after gamete intrafallopian transfer (GIFT) with the cumulative spontaneous pregnancy rates in couples with unexplained infertility. Design-A contemporaneous study in a single group of patients. Setting-Northern Regional Fertility Centre. Subjects-76 couples with unexplained infertility of more than 3 years duration. Interventions-Successful pregnancies were recorded during at least 3 months bcfore GIFT and up to 21 months after a maximum of three cycles of GIFT trcatment. Main outcome measures-Pregnancy resulting in a live birth. Results-Average monthly fecundability without treatmcnt was 0-021 and after GIFT was 0.14 (P<0.001). This was reflected as a cumulative pregnancy rate of 52% after three cycles of GIFT and 30% after 24 months without treatment. Conclusions-The chance of having a baby after one cycle of GIFT is significantly greater than the chance in a spontaneous cycle. However, considering the cumulative pregnancy rates, we suggest that if G I m is to be a realistic treatment option, it should be offered for more than one cycle. Gamete intrafallopian transfer (GIFT) (Asch et al. 1985) is increasingly recommended as the treatment of choice for unexplained infertility.
Simultaneous in vitro fertilization and gamete intrafallopian tranfer (GIFT)
Fertility and Sterility, 1987
During a 6-month period, a combination of gamete intrafallopian transfer (GIFT) and in vitro fertilization (lVF) was offered to all couples beginning an IVF treatment cycle in whom the wife had anatomically normal fallopian tubes. It was recommended to these couples that sufficient oocytes be reserved for insemination in vitro to determine whether the husband's spermatozoa could fertilize the wife's oocytes. During this interval, 16 couples underwent the combined IVF-GIFT procedure. All of the IVF-GIFT couples had at least two oocytes inseminated in vitro and at least two oocytes for GIFT. Of the 16 IVF-GIFT couples, only 1 (625%) achieved a clinical pregnancy. More important, 50% (8116) of the IVF-GIFT couples had no oocytes fertilized in vitro. With the information concerning lack of fertilization in vitro, appropriate recommendations concerning future fertility management can be made. If the same couples had undergone the GIFT procedure alone, without additional oocytes fertilized in vitro, this information would not have been obtained.
Reproductive surgery in infertility
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2017
Background: With recent improvements in the assisted reproductive technology (ART), there has been a growing tendency that bypasses diagnostic laparohysteroscopy and proceeds directly to ART. Therefore, the value of diagnostic laparohysteroscopy in current fertility practice is under debate. In the present study, we evaluated the usefulness of diagnostic laparoscopy and hysteroscopy for patients with infertility.Methods: This retrospective study was conducted at Safal Hospital, Nagpur from January 2017 to July 2017. 80 patients were selected for this study who had undergone diagnostic laparohysteroscopy for infertility.Results: In present study, out of 80 patients studied, 66.25% patients had normal hysteroscopy findings, in 10% of patients, tubal cannulation was done for cornual block, in 6.25% of patients, resection of uterine septum was done, adhesiolysis for asherman’s syndrome was done in 5% of patients, endometrial polyp was removed in 5% of patients, 2.5% patients had resecti...