ABSTRACT
Background. A prospective randomised controlled trial comparing gamete intrafallopian transfer (GIFT) with intrauterine insemination (IUI) was undertaken at the Fertility and Reproductive Biology Unit of the Department of Obstetrics and Gynaecology; Tygerberg Hospital; between July 1999 and June 2000. Method. Eighty-five women were included the study and were randomly allocated between the two groups after routine infertility investigations; 41 women to IUI and 44 women to GIFT. A combination of clomiphene incitrate and human menopausal gonadotropin was administered to both groups to achieve ovulation. Results. Six (13.6) of the 44 cycles in the IUI group and 24 (53.3) of the 45 cycles in the GIFT group achieved conception. The mean number of cycles needed to achieve pregnancy in IUI was 7.3 (44/6) and in GIFT was 2.05 (45/24). The ongoing pregnancy rate of GIFT was 39.7 more effective than that of IUI (p=0.0001.The total ongoing pregnancy rate of GIFT was 30.8 superior to that of IUI (p=0.0021). When 2 folli-cles were obtained in an IUI cycle; GIFT was 41.6 more effective (p=0.0024); and when more than 2 follicles were obtained; GIFT was 28.3 more effective (p=0.0265). Conclu- sions. The number of mature follicles significantly increased the chance of pregnancy with IUI. In comparing the number of cycles needed to achieve a pregnancy; 1 GIFT cycle is equivalent to more than 3 IUI cycles. It is important to note that 4 IUI cycles will give equivalent or even better results if 2 - 3 follicles are recruited per cycle. In spite of the greater efficacy of GIFT; the authors conclude that at least 3 to 4 IUI cycles should be attempted before GIFT; on the basis that it is more cost effective and less invasive
Subject(s)
Gamete Intrafallopian Transfer/methods , Infertility/therapy , Insemination , Pregnancy Outcome , Randomized Controlled TrialABSTRACT
This report summarises the result of the GIFT program at Ramathibodi Hospital during 1990-1991. There were 35 treatment cycles in 34 infertile couples. The age of the females varied from 29 to 41 years. Duration of infertility was 3 to 10 years. GIFT was performed during diagnostic laparoscopy in 26 cycles (78%). Other indications were endometriosis (5 cycles), concurrent with myomectomy (3 cycles) and unexplained infertility (1 cycle). Two cases received CC+HMG for superovulation, the others had GnRHa+HMG. Transvaginal ultrasound guided oocyte pick up yielded 2 to 10 oocytes (mean 5.8 oocytes per cycle). Two to 8 oocytes were transferred. All patients received progesterone or HCG for luteal support. In cases of diagnostic laparoscopy, the findings were normal (10 cases), endometriosis (7 cases), pelvic adhesion (6 cases) and myoma uteri 3 cases). No pregnancy was achieved among 18 GIFT cycles performed in 1990. In 1991, after changing some instruments and methods, there were 5 pregnancies out of 17 GIFT cycles (29%). The factors that influenced the outcome were good selection of instruments and method, maturity of oocytes and semen parameters.
Subject(s)
Adult , Female , Gamete Intrafallopian Transfer/methods , Humans , Infertility, Female/etiology , PregnancyABSTRACT
En la unidad de Fertilidad y Esterilidad de la Clínica Avila de Caracas (UNIFERTES), entre 1988 y 1990 se practicaron treinta transferencias intratubarias de gametos (GIFT) a veinte y seis pacientes con historias de esterilidad de dos o más años de evolución, las cuales fueron estudiadas desde el punto de vista de fertilidad sin la laparoscopia diagnóstica previa. Las pacientes fueron sometidas a estimulación ovárica con citrato de clomifeno más MG más H.C.G y monitorizada su evolución con ultrasonografía transvaginal y valores de estradiol sérico. Transferimos de 3 a 5 oocitos metafase II en una o ambas trompas, con un número de espermatozoides mótiles entre 100.000 y 150.000 por ml. Se obtuvieron nueve embarazos (30%), siendo éxito seis de ellos (20%), terminando 3 de en parto vaginal y 3 en cesárea. El peso promedio de los niños al nacer fue de 3112 g. No hubo malformaciones congénitas