An alternative to in vitro fertilization-embryo transfer: the successful transfer of human oocytes and spermatozoa to the distal oviduct.

In vitro fertilization-embryo transfer (IVF-ET) for treatment of irreparable tubal damage provides a means for otherwise hopelessly infertile couples to obtain offspring. Recently a simpler and less expensive procedure was applied as an alternative to IVF-ET to patients with at least one patent fallopian tube. This procedure employs stimulated ovarian cycles, washed and cultured sperm, and laparoscopic aspiration of oocytes. Recovered oocytes and sperm are deposited in the ampulla of the oviduct by means of a catheter. From February 1 to September 28, 1985, 137 cycles yielded 60 laparoscopies (51 patients). Elevated human chorionic gonadotropin observed in 18 cases was confirmed in 12 cases by ultrasound. Nine uterine pregnancies continued with no tubal pregnancy. Success is comparable for this new procedure and IVF-ET. The results suggest that many IVF-ET patients should be offered the simpler and less expensive option of tubal transfer (TT).