Early experience with the GIFT procedure.

Gamete intrafallopian transfer (GIFT) was performed in 19 cycles on 15 couples whose infertility had proven resistant to other treatments. Indications included infertility associated with immunologic factors, seminal deficiencies, endometriosis and infertility without a diagnosed etiology. Any history or finding of tubal disease served as an exclusion. Infertility was primary in ten couples and secondary in five, three of whom had conceived previously with a semen donor. Stimulation protocols included clomiphene citrate (CC) and human menopausal gonadotropins, CC alone and gonadotropins alone. Males were screened with the hamster egg sperm penetration assay. Four conceptions were recorded, and three are ongoing. Advantages of this procedure include acceptance by the major orthodox religions, avoidance of extracorporeal incubation and physiologic entry of the embryo into the uterine cavity. Disadvantages include the inability to determine if fertilization has occurred in the absence of pregnancy, the theoretical risk of increased ectopic gestation and tubal infection, and perhaps an increase in multiple gestations.