What is ZIFT?
Zygote
intrafallopian transfer (ZIFT) is
a type of infertility treatment that
combines the techniques of in vitro
fertilization (IVF)
and gamete intrafallopian transfer
(GIFT).
In both GIFT and ZIFT, the fallopian
tubes are the point of insertion:
experts believe that this contributes
to their high rates of success. In
GIFT, the gametes are placed into
the fallopian tubes where they fertilize
on their own. In ZIFT, however, the
gametes are placed together outside
the body in the laboratory. Once they
form a zygote, it is placed in the
fallopian tubes.
The ZIFT process is
designed for couples for whom conception,
for whatever reason, does not occur
on its own within the fallopian tubes.
At the same time, the procedure capitalizes
on the high rate of success that apparently
results from insertion into the fallopian
tubes. The success rate of ZIFT is
approximately twenty-eight percent,
only slightly lower than the thirty-five
percent success for GIFT patients
and significantly higher than IVF.
ZIFT is also believed to have a lower
incidence of multiple pregnancy than
GIFT.
Who
is a candidate for ZIFT?
ZIFT
is an option for many types of infertility.
The clear exceptions are when the
woman has damage or abnormalities
in both fallopian tubes, or if the
man’s sperm is incapable of
fertilizing an egg. It is best to
consult a qualified fertility doctor
to find out if ZIFT is appropriate
or if there are any conditions that
might preclude a couple from undergoing
the procedure.
How
is the procedure performed?
Patients seeking infertility
treatment meet with a fertility doctor
a few weeks before the surgery. If
the doctor determines that the couple
is a good candidate for ZIFT, the
woman begins a series of drugs to
promote the production of multiple
eggs. The doctor also advises the
couple on how to adjust their lifestyles
to prepare for surgery.
On the day of the
procedure, the fertility doctor will
start by collecting sperm from the
male. If possible, the male provides
a semen sample by ejaculation; if
not, the doctor employs a surgical
technique to remove semen from either
the testes or the epididymis. The
semen is then put in a centrifuge,
which separates the sperm from the
other contents. The sperm is washed
and put aside.
Next, the doctor must
extract the eggs from the woman’s
ovaries. One method of extraction
is laparoscopy, in which a tiny telescopic
device and other surgical instruments
extend through an incision in the
abdomen into the ovaries. The other
method is called transvaginal removal.
In this procedure, the doctor uses
a sonogram to guide a needle through
the cervix and into the ovaries.
Once the eggs and
sperm are extracted and prepared,
they are placed into a petri dish
together. The sperm fertilizes the
eggs, but they are not allowed to
perform cellular division and form
an embryo. In this state, the fertilized
eggs are termed zygotes, and because
they would naturally form in the fallopian
tubes, this is where the doctor –
using laparoscopy – inserts
them. Because it is the fertility
doctor’s task to promote the
growth of a single fetus whenever
possible, he or she inserts the fewest
number of eggs that will provide a
reasonable chance of pregnancy. After
the eggs have been inserted, the woman
lays down for about an hour and then
returns home, where she tries to avoid
activity for a few days. The fertility
doctor sees her a few weeks later
for a pregnancy test.
As with other ART
procedures, the primary risk of ZIFT
is multiple pregnancy. At one in four,
the rate of multiple pregnancy in
successful ART procedures has gone
down in recent years, as doctors have
become more proficient at fertility
treatments and can afford to use fewer
eggs to induce pregnancy. However,
in cases where multiple pregnancy
does occur, there are increased health
risks to both the mother and the fetuses.
Severe ovarian hyperstimulation, another
side effect of ZIFT, is fairly rare,
but the fluid that it causes to collect
in the abdominal area can cause damage
to the organs there. Finally, while
laparoscopy is fairly safe, it can
cause infection or puncture organs
in the abdomen. It also requires the
use of general anesthesia, which can
cause complications as well.
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