Hysteroscopic gamete intra-fallopian transfer: a good alternative, in selected cases, to laparoscopic intra-fallopian transfer.

Results obtained in two groups of patients treated with gamete intra-Fallopian transfer (GIFT) are reported. Hysteroscopic GIFT was carried out in some cases where general anaesthesia was not advisable or possible, i.e. difficulties in tubal catheterization due to pelvic adhesions, extended distal tubal damage, patients' intolerance, lack of available operating theatre. Ovarian stimulation was started on 131 patients for a total of 147 cycles. Twenty-five cycles were cancelled because of failure of the ovarian response. Either laparoscopic (group 1; 73 patients) or hysteroscopic GIFT (group 2; 50 patients) was performed. In group 1 a mean of 6.8 +/- 3.4 oocytes per cycle were retrieved and a mean of 4.7 +/- 1.3 mature oocytes were transferred. The pregnancy rate was 30.1% per retrieval (22 clinical pregnancies). In group 2, a mean of 5.0 +/- 3.1 oocytes was harvested and 3.9 +/- 2.0 mature oocytes per cycle were transferred. Thirteen clinical pregnancies were achieved (26.5% per cycle) in group 2. Comparing the two groups, the number of recovered and transferred oocytes was significantly lower in hysteroscopic GIFT (P less than 0.05 and P less than 0.001 respectively).