(2007-03-30) Beyond In Vitro Fertilization

Couples typically begin treatment with simple and relatively inexpensive intervention

(AddPR) Tarzana, CA - The roller coaster ride of fertility treatment is emotionally and physically exhausting. Couples typically begin treatment with simple and relatively inexpensive interventions such as ovulation induction and intrauterine insemination (IUI), and when treatment has failed, progress to injectable medications and finally in vitro fertilization (IVF). Each treatment protocol may last up to one month and several cycles of the same method are often repeated to maximize chances for success.

The IVF process, while expensive and physically demanding, has been associated with the highest success rates of all treatment modalities. However, many couples remain childless after one or more attempts. Couples who have failed IVF multiple times are often depressed, angry, disappointed, discouraged, and in general emotionally, physically, and financially drained. If IVF, the procedure with the highest success rate for achieving pregnancy, has failed, what other hope is there?

When standard IVF has failed multiple times, some infertility specialists offer couples a procedure in which gametes (eggs and sperm) or zygotes (day-one embryos) are transferred into the fallopian tubes: gamete intra-fallopian transfer (GIFT), or zygote intra-fallopian transfer (ZIFT). In GIFT and ZIFT, all steps from downregulation to ovarian stimulation to egg retrieval, are identical to standard IVF. However, several important differences exist. In a GIFT procedure, retrieved eggs and sperm are mixed together and transferred into one or both fallopian tubes (where natural fertilization normally occurs). In a ZIFT procedure, on the other hand, fertilization is allowed to take place in the laboratory just like in standard IVF, however when day-one embryos are formed, they are transferred into the fallopian tube(s).

About Us: Center for Fertility and Gynecology
Infertility practice specializing in IVF, donor eggs,male factor infertility, and other advanced fertility treatments. Located in Tarzana, California.website : http://www.vermesh.com

Contact Info: The Center for Fertility and Gynecology
18370 Burbank Blvd Suite 301
Tarzana, CA 91356
Phone: (818) 881-9800
Fax: (818) 881-1857

Additional: FREQUENTLY ASKED QUESTIONS?

Am I a candidate for GIFT/IVF or ZIFT/IVF despite being a poor responder?

The usual number of eggs/embryos used for transfer to the fallopian tubes is 3, while the number of embryos transferred trans-cervically is typically 2. Therefore, a GIFT/IVF or ZIFT/IVF cycle would require that at least 5 eggs/embryos are available for transfer. If you had previously responded poorly to a stimulation protocol (< 5 eggs), it is possible to freeze embryos in 1 or 2 consecutive cycles until enough embryos are accumulated in order to complete a GIFT/IVF or ZIFT/IVF cycle.

How does a history of poor quality embryos affect success with GIFT/IVF or ZIFT/IVF?

Embryo quality may be determined by many factors such as the stimulation protocol, egg quality, and sperm quality. Some embryos may further be over-sensitive to laboratory conditions, which can contribute to poor development. Placement of such embryos in their natural environment, the fallopian tube (as is done with GIFT/IVF and ZIFT/IVF) at the critical early stages of development may enhance their ability to survive and ultimately implant in the uterus. In fact, a history of poor embryo quality may be an indication for GIFT/IVF or ZIFT/IVF.

Will I have enough time to recover from surgery prior to undergoing trans-cervical embryo transfer?

A standard GIFT or ZIFT procedure at our Center lasts an average of 15 minutes. This means the recovery time from surgery and anesthesia is very rapid and will not affect your trans-cervical embryo transfer 2 or 3 days later. Most patients resume normal daily activities within 12-24 hours of laparoscopy.

What are the basic requirements prior to GIFT/IVF or ZIFT/IVF?

Several limitations exist with either a GIFT or ZIFT procedure. First, tubal embryo transfer is not suitable for patients with tubal factor infertility, as at least one normal tube has to be present. An x-ray test called a hysterosalpingogram (HSG) would be required before surgery to confirm tubal patency. Second, not all fertility programs can offer this procedure since it requires surgical intervention at the time of, or one day following, the egg retrieval procedure. This requires that a laboratory equipped to handle gametes and embryos be in close proximity to an operating room.

Eliran Mor, MD and Michael Vermesh, MD can be reached at 818-881-9800 or www.vermesh.com

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Phone: (818) 881-9800