GAMETE INTRAFALLOPIAN TRANSFER (GIFT)

     The gamete intrafallopian transfer Gift ( gamete intrafallopian transfer ) is a gynecological technique against situations of sterility, by transferring the egg and sperm, separately, the woman 's body in one of the fallopian tubes, to enable they can join and fertilization occur.

                                                    METHOD

     First, the woman must take a medication to stimulate egg production in the ovaries. The doctor will monitor the growth of ovarian follicles, and once they have reached maturity, human chorionic gonadotropin (hCG) is injected into the woman. The eggs will be collected approximately 36 hours later, mixed with the man's sperm and placed back into the woman using laparoscopy.

After loading the catheter gametes, transported to the operating room sterile way and there, by surgery or transvaginal, the fallopian tube is cannulated to empty its contents into her, 2 cm from the ampullary end. After the anesthesia, clinical discharge is given to the woman the same day.

Progesterone treatment is started from the third day after the transfer have been made, and held until the eighth or tenth week

                         Transfer of gametes in the fallopian tube (GIFT)

     The GIFT (the stands for gamete intrafallopian transfer) is particularly suitable for couples with proven fertilizing capacity of sperm. It is also appropriate for cases of infertility by seemingly unknown causes and couples with minor alterations Seminal.

                         What is the treatment?

     The GIFT is a method of assisted reproduction, which aims to ensure that the sperm fertilize eggs within the fallopian tube. Therefore, it is a requirement that at least one of your fallopian tubes is healthy.

                        How many stages comprises treatment?

The stages are three: stimulation of ovulation, follicular aspiration and laparoscopy.

                        What stage of ovulation stimulation is under GIFT?

     During a spontaneous ovulatory cycle, of all follicles (ovary structure within which the eggs are) no more than one reaches maturity. The rest are reabsorbed and participates only one egg in each process of the reproductive cycle. On extraordinary occasions more than one follicle matures, with the consequent production of more than one egg. The result may be not identical twins spontaneously. 

The aim of ovulation stimulation is to recruit a greater number of ova in both ovaries, preventing reabsorption other dominant follicles accompanying. This allows for a higher amount for once aspirates the ovary, they can be fertilized. The importance of this is that, depending on the age of women, some eggs produced spontaneously have chromosomal alterations, which do not prevent fertilization but implantation and normal development of the embryo. 

At fertilize more than one egg, several embryos are obtained and having a higher probability of one is regularly constituted can be implemented. Undoubtedly, the transfer more eggs increases the probability of pregnancy and thus a  multiple pregnancy . 

Stimulation of ovulation lasts 10 to 12 days. During this period, to evaluate the growth and development of follicles, ultrasound follow - up, consisting of 3 or 4 transvaginal ultrasound done, and blood samples were also taken to measure the level of estradiol ( a hormone produced by the follicle) which increases as the follicles grow. When most of them reached an average size between 18 and 20 millimeters, a hormone called HCG, which is responsible for completing the follicular maturation is injected. 36 hours after the aspiration is performed.

                   What is follicular aspiration in the context of this treatment?

     This is a procedure that aims to extract the eggs inside follicles and is performed by puncturing the ovary with a needle inserted through the bottom of the vagina, guided into the follicles by ultrasound visualization. The procedure is ambulatory and, depending on the patient and the topographic location of the ovaries, may require local or general anesthesia. 

For this stage of treatment, you should hospitalize fasting. Immediately after obtained, the eggs are classified morphologically and stored in the incubator in capsules containing culture medium and that have been previously labeled with your name. Follicular aspiration takes about 30 minutes. 

Meanwhile, your partner can bring the semen sample directly from your home or produce in the laboratory. If it is brought from home it should be delivered to the laboratory ideally within an hour of produced and maintained at no lower than 20 degrees temperatures. The semen is processed in order to concentrate on culture media (equal to eggs) a subpopulation of mobile sperm acquire the ability to fertilize. 

After follicular aspiration can feel a small abdominal pain, which subsides with the use of analgesics and disappears during the day. You are also likely to have vaginal bleeding. However if you present fever, severe pain or excessive bleeding you should inform your doctor immediately.

                                  What is the third stage of this treatment?

     This body, called laparoscopy will be done to you under general anesthesia and is the time when a thin catheter through one tube, which inside contains the eggs and sperm separated by an air bubble is introduced. 

The next day, you will receive support daily hormone progesterone. The route of administration may be intramuscular or vaginal and occasionally orally. The hormone supplement is maintained daily until detection of pregnancy. If you are pregnant Progesterone supplementation is continued for five weeks. While it is not absolutely proven, there is some evidence to suggest that embryo implantation and maintenance of pregnancy are enhanced by the use of supplemental progesterone. 

Fourteen days after the GIFT can be measured in your blood hormone (beta-HCG) that allows detecting the presence of pregnancy. This value doubles every 1.5 to 2 days. Thus, serial measurements may provide useful information on the quality of gestation before being visible with transvaginal ultrasound, 21 days after the procedure.

What are the chances of success of this treatment?

The results depend on fertility problems and ages of both partners. Young women, then, is generally healthier eggs and higher chances of success. On average, you have a 21% chance of getting pregnant each cycle of treatment.