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 You are here : Home / Fertility / Additional Treatments / ZIFT

ZIFT

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Zygote intrafallopian transfer (ZIFT) is an infertility treatment where a blockage in the fallopian tubes prevents the normal binding of sperm to the egg. Egg cells are removed from a woman's ovaries, and in vitro fertilised. The resulting zygote is placed into the fallopian tube by the use of laparoscopy. The procedure is a spin-off of the gamete intrafallopian transfer (GIFT) procedure. ZIFT has a success rate of 64.8% in all cases.


TET and ZIFT vs IVF

Some studies have shown higher implantation rates with ZIFT/TET as compared to in vitro fertilization (IVF) with uterine embryo transfer or GIFT.

Patient selection is usually a potential confounding issue.

Few randomized trials have been done. Those that have either show no difference or a benefit to tubal transfers.

Outcome can potentially be very physician dependent.

Some physicians have much lower IVF - uterine transfer rates than others.

The best setting for a randomized trial would be a program with all physicians having high pregnancy rates for uterine transfers.

Tubal assisted reproduction procedures (GIFT, ZIFT, TET) are unlikely to ever be cost-effective because of the additional cost of laparoscopy.


How are TET and ZIFT performed?

  1. Consents are signed by all parties.
  2. The woman is stimulated with medications to develop multiple egg development.
  3. When the woman's follicles are mature, an aspiration procedure is performed to remove the eggs from her ovaries. The eggs are then fertilized in the laboratory with her partner's sperm.
  4. The embryos are cultured in the laboratory for 1 day for ZIFT and 2 days with TET. At that time, a tubal transfer procedure (surgery with laparoscopy) is done which places the embryos in the woman's fallopian tubes.

Procedure

It takes, on average, five weeks to complete a cycle of ZIFT. First, the woman must take a fertility medication to stimulate egg production in the ovaries. The doctor will monitor the growth of the ovarian follicles, and once they are mature, the woman will be injected with human chorionic gonadotropins (hCG). The eggs will be harvested approximately 36 hours later, usually by transvaginal ovum retrieval. After fertilization in the laboratory the resulting early embryos or zygotes are placed into the woman's fallopian tubes using a laparoscope.

One disadvantage with ZIFT is that the transfer of the zygote must be performed through a laparoscope. This involves a surgical incision, whereas with IVF, the fertilized eggs are transferred through the vagina without the need for any incisions. Although laparoscopy is a minor surgical procedure, it still adds to the complexity, risk, and cost of the entire process.

ZIFT requires that the woman have at least one functioning fallopian tube. Therefore, ZIFT is not an option in women with infertility caused by tubal problems. However, like IVF, it is possible to determine whether fertilization has taken place. The obvious advantage of ZIFT is that ZIFT uses zygotes, not an egg and sperm mixture.

Essentially GIFT and ZIFT are analogous procedures, however their specific features justify their utilization in different circumstances. Patients with failed GIFT procedures or in cases where there's some doubt about the sperm's ability to fertilize the egg, ZIFT may be a better option than GIFT. With ZIFT, fertilization is documented prior to replacement of the zygote into the fallopian tube. ZIFT may be indicated if additional procedures need to be implemented to fertilize the oocytes such as in cases of severe male factor infertility where ICSI may be necessary.

Also ZIFT may be a preferred alternative if you want to decrease the probability of multiple pregnancy. A few zygotes are selected for fresh transfer depending upon their quality. The number of zygotes transferred seeks to maximize the pregnancy rate without increasing considerably the probability of a multiple pregnancy.



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