GIFT

These days, Gamete intra-fallopian transfer (GIFT) tends to be reserved for poor prognosis patients and is no longer widely used as an alternative to IVF. The available success rate data  are so limited or out-of-date that they cannot act as a reliable guide, but GIFT does carry an increased risk of multiple pregnancy.

The outcome inevitably reflects the patient profiles (particularly age and whether the patients had opted for GIFT for religious, rather than medical reasons) and the number of eggs transferred per cycle.

What is the official guidance?

The current Human Fertilisation and Embryology (HFEA) guidelines state that:

Where a woman is to receive treatment using her own eggs, or embryos created using her own eggs, whether fresh or previously cryopreserved:

1. where the woman is aged under 40 at the time of transfer the centre should not transfer more than two eggs or two embryos in any treatment cycle, regardless of the procedure used; 
2. where the woman is aged 40 or over at the time of transfer the centre should not transfer more than three eggs or three embryos in any treatment cycle, regardless of the procedure used.

This guidance is currently under review and an update is scheduled for late spring.

Minimising the risks

To balance the risks of multiple pregnancy with the chance of a positive outcome, the following approach is recommended:

• It is important to consider the clinical prognosis when deciding on the number of eggs to transfer.
• Where GIFT is chosen by patients due to their religious views, and where these patients have a favourable prognosis, the number of eggs transferred should be kept to a minimum.
• Where relevant, explain to patients the risks of multiple pregnancy associated with multiple egg transfer and to give details of the types of problems that accompany multiple pregnancies and multiple births. See What are the risks for more information.
• Follow up with written information (brochures, leaflets, etc).