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GIFT and ZIFT WebMD Medical Reference GIFT (gamete intrafallopian transfer) and ZIFT (zygote intrafallopian transfer) are modified versions of in vitro fertilization. Like IVF, these procedures involve retrieving an egg from the woman and re-implanting it, but in GIFT and ZIFT the process goes more quickly. While in traditional IVF the embryos are observed and raised in a laboratory for 3 to 5 days, in ZIFT, the fertilized eggs -- at this stage called zygotes -- are placed in the fallopian tubes within 24 hours. In GIFT, the sperm and eggs are just mixed together before being inserted and, with luck, one of the eggs will become fertilized inside the fallopian tubes. So what's the advantage to these procedures? The success rates are similar to IVF, and for some women who haven't been able to get pregnant with normal in vitro fertilization, GIFT or ZIFT may be a good idea. The processes used in GIFT and ZIFT are closer to natural conception. In ZIFT, the eggs are placed in the fallopian tubes rather than directly in the uterus. With GIFT, fertilization actually takes place in the body rather than in a petri dish. However, as in vitro fertilization techniques have become more refined, GIFT and ZIFT have become less needed. And since GIFT and ZIFT both require a surgical procedure that IVF does not, IVF is almost always the preferred choice in clinics. In vitro fertilization accounts for at least 98% of all assisted reproductive technology procedures performed in the U.S., while GIFT and ZIFT make up less than 2%. What Types of Infertility Can They Treat? GIFT and ZIFT can be used to treat many types of infertility, except cases caused by damage or abnormalities of the fallopian tubes. These techniques can also be used in cases of mild male infertility, as long as the sperm is capable of fertilizing an egg. If the woman is not capable of producing eggs that can be used in GIFT, but her partner's sperm is capable of fertilization, they might consider getting eggs from a donor. One reason for using an egg donor is age. Women over 35 are less likely to have viable eggs and more likely to have children with birth defects than younger women. A woman with premature ovarian failure, a condition in which menopause has begun early, might also consider a donor if she wants to carry a child. Most egg donation is anonymous, but some couples prefer to know their egg donor and take legal steps to contract for the donation of the eggs. GIFT: What You Can Expect The initial process for GIFT is the same as it would be for in vitro fertilization: treatment with injectable hormones to start superovulation, followed by further injections of a medication that ripens the developing eggs. The facility where the procedure will be done will provide you with special instructions to prepare you for the procedure. The eggs and sperm are collected just as they would be in an IVF procedure, but after that, the two techniques differ. In IVF, the embryo is placed into the uterus with a catheter inserted into the vagina in a quick and simple procedure. In GIFT, an incision has to be made in the abdomen and the eggs and sperm are placed in the fallopian tubes using a laparoscope, a small telescope-like instrument. A laparoscopy requires general anesthesia, although it can still usually be performed as an outpatient procedure. If all goes well, once the eggs are in the fallopian tubes, at least one will become fertilized by the sperm and move on to the uterus where it will mature. But, because the eggs and sperm are placed into the fallopian tubes before conception, there's no way to know if fertilization has taken place. Typically, more eggs are used in GIFT to ensure pregnancy, which also increases the risk of multiple births. The American Society of Reproductive Medicine recommends that GIFT only be performed in a facility that is prepared to carry out IVF as an alternative or in addition to GIFT. ZIFT: What You can Expect This procedure is similar to GIFT in that the assisted reproduction is done in the fallopian tubes. The difference is that with ZIFT the sperm and egg are mixed together in the laboratory, and given time to fertilize, before being placed in the fallopian tubes. In this sense, ZIFT is closer to traditional in vitro fertilization. ZIFT, like GIFT, requires treatment with hormones, and the procedure is performed by laparoscopy. Because ZIFT allows for fertilization to be confirmed before the eggs are inserted into the fallopian tubes, fewer eggs are usually used, lowering the risk of multiple pregnancy. Success Rates The CDC groups together all procedures that constitute assisted reproduction technology (ART) including in vitro fertilization, GIFT, and ZIFT. So there's no way to know the success rates of each technique. Combined, however, the most recent report, from 2000, found:
The Costs Both procedures are expensive, at least $12,400 and often more. The cost will vary depending on where you live, the amount of medications you are required to take, the number of cycles you undergo, and the amount your insurance company will pay toward the procedure. GIFT and ZIFT may cost more than traditional in vitro fertilization. You should thoroughly investigate your insurance company's coverage of GIFT and ZIFT and ask for a written statement of your benefits. Although some states have enacted laws requiring insurance companies to cover at least some of the costs of infertility treatment, many states haven't. Also be aware that some carriers will pay for infertility drugs and monitoring but not for the cost of assisted reproductive technology. RESOLVE: The National Infertility Association, publishes a booklet called the "Infertility Insurance Advisor," which provides tips on reviewing your insurance benefits contract. RESOLVE's web site is www.resolve.org.
Reviewed by Charlotte E. Grayson, MD. Published September 2003. SOURCES: American Society for Reproductive Medicine web site. Aerican College of Obstetricians and Gynecologists web site. WebMD Fertility Center web site. Human Reproduction Update, July-August 2002. The Infertility Workup and Understanding Treatment Options, RESOLVE online. The Merck Manual, Seventeenth Edition, 2000. The Fertility Handbook: A Guide to Getting Pregnant, Addicus Books, 2002. Assisted Reproductive Technology Success Rates, 2000, CDC. |
WebMD does not provide medical advice, diagnosis or treatment. See additional information.
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