Gamete Intra-Fallopian Transfer with Donor Eggs

Gamete Intra-Fallopian Transfer (GIFT) is an assisted reproduction technique used to help infertile couples conceive. The procedure can be preformed using the women’s own ova (eggs) or with donor eggs from others. It is an effective fertility option for women who wish to conceive naturally.

Gamete Intra-Fallopian Transfer (GIFT) requires structural integrity of the female reproductive tract since the purpose is to conceive in its natural place, the fallopian tube. Often the woman undergoes specialised tests to examine the fallopian tubes for any structural abnormalities. It is imperative to have at least one normal fallopian tube, requiring sometimes an initial laparoscopic study to view tubes and ensure their permeability. GIFT using donor eggs are specially indicated in couples with proven sperm fecundabilty.

Many people often get confused between In Vitro Fertilisation (IVF) and GIFT. The difference is mainly the fertilisation site. In the former, fertilisation is produced in the laboratory; whilst in the latter it occurs naturally in the tubes. Depending on the number of eggs to be retrieved, the procedure lasts between 30 and 60 minutes.

Gamete Intra-Fallopian Transfer is a procedure usually preformed by a fertility specialist. The stages of the procedure are described below:

Ovulation Stimulation

The first is similar to IVF. The eggs are collected from the would-be mother, usually following stimulation with fertility drugs. This helps ensure an appropriate number of suitable eggs are harvested. The developing eggs will be monitored by ultrasound scans as well as blood and urine tests and when it is considered appropriate, the woman will receive an injection of Human Chorionic Gonadotrophin (HCG).

The purpose of ovulation stimulation is to recruit a larger number of eggs in both ovaries and to prevent reabsorption. In cases where donor eggs are used; ovulation stimulation will not be required since the ova are recruited from an external source.

Follicular Aspiration

Follicular aspiration is a procedure designed to extract the eggs from within the follicles. It is preformed by puncturing the ovary with a fine needle, which is introduced through the vagina. The needle is then guided to the ovaries using ultrasound. This is an ambulatory procedure, meaning it can be done in the doctor’s office, but it does require local anesthesia. In complicated cases the procedure may require general anaesthesia.

Laparoscopy

The retrieved eggs will be inspected and the best will be selected. Using a laparoscope under general anaesthesia, the selected ova will be transferred to the fallopian tube. The eggs along with a fresh sample of her partner’s sperm are delivered together to the fertilisation site using a long thin catheter. The catheter is guided via a laparoscope to ensure proper delivery at the appropriate site. The sample sperm is usually produced in the same morning of the scheduled procedure.

The catheter is then gently inserted via the laparoscope, into the outer ends of one or both fallopian tubes and the egg and sperm (gametes) and flushed into the woman's fallopian tubes so that fertilisation occurs inside the body. Any remaining eggs are usually inseminated and cultured as for IVF, and any resultant embryos can then be frozen for future use.

The next morning the patient receives daily supplementary support with progesterone. It can either be injected or administered orally. Hormonal support is preserved until pregnancy is detected. If she is pregnant, supplement will be continued for another five weeks to promote embryonic implantation and pregnancy preservation. ß-HCG can document the presence of pregnancy, by doubling its value every 1 to 2 days. Serial measurements of ß-HCG in the blood can provide useful information about the pregnancy even before the foetus is detected via ultrasound.