Births after transcervical gamete intrafallopian transfer with a falloposcopic delivery system.

OBJECTIVE

To evaluate the safety and efficiency of a new delivery system to perform transcervical GIFT.

DESIGN

Evaluation of pregnancy rate (PR), miscarriage rate, ectopic pregnancy rate, and delivery rate.

SETTING

Institute of Obstetrics and Gynecology, Reproductive Endocrinology Unit, Infertility and IVF Center.

PATIENT(S): Twenty-five patients with patent tubes documented by laparoscopy plus falloposcopy.

INTERVENTION(S): Superovulation was induced with GnRH analogue and FSH. Under laparoscopic control, transcervical cannulation of the tube was done using a linear everting catheter incorporating direct falloposcopic vision of the tubal lumen. Two lengths of everting catheter (3 and 6 cm) were used providing either isthmic-ampullary or midampullary placement of the inoculum. A comparison was done in terms of ease of access and transfer, falloposcopic observations, and PRs between the groups.

MAIN OUTCOME MEASURE(S): Efficacy was established by evaluating the PR, miscarriage rate, ectopic pregnancy rate, and delivery rate.

RESULT(S): The PR was 28% (with no differences between the lengths of everting catheters). No ectopic pregnancies occurred. The abortion rate was 28.6% and the delivery rate was 20%. Neither tubal perforation nor other complications occurred during the procedure.

CONCLUSION(S): Falloposcopic GIFT is safe and efficient and may be a less invasive alternative than laparoscopic transfer.