San Diego's Premier Fertility Center: Reproductive Sciences Center & Genetics Institute

Advanced Fertility Treatment Options

When basic fertility treatments fail or when the reason for a couple's infertility is such that basics treatments are not appropriate, couples turn to advanced fertility treatments. Collectively advanced fertility treatments are known as Assisted Reproductive Technologies (ART). The availability of ART has revolutionized the treatment of infertility, making many previously difficult or impossible infertility problems simple to overcome. Using the full range of ART, virtually all couples can successfully become pregnant. The infertility doctors at Reproductive Sciences Center work with each couple to find the most effective and cost-effective treatment for them.

Available Treatments

• In Vitro Fertilization (IVF)
• Intracytoplasmic Sperm Injection (ICSI)
• Preimplantation Genetic Diagnosis (PGD)
• Gamete Intrafallopian Transfer (GIFT)
• Tubal Embryo Transfer (TET and ZIFT)
• Frozen Embryo Transfer (FET)
• Egg (Oocyte) Freezing
• Traditional Surrogacy
• Gestational Surrogacy
• Assisted Hatching
• Assisted Egg Activation
• Cytoplasmic Transfer--Presently Not Available
• Egg Donation
• Embryo Donation
• Microsurgical Sperm Aspiration (MESA)
• Testicular Sperm Extraction (TESE)

Gamete Intrafallopian Transfer (GIFT)

What is Gamete Intrafallopian Transfer?
An ART procedure in which eggs are removed from a woman's ovaries, combined with washed sperm, and then both eggs and sperm are placed into the woman's fallopian tube(s) through a small incision in her abdomen.

The procedure is performed by laparoscopy. GIFT is an advanced fertility treatment that was introduced in 1984 that by-passes one of the functions of the fallopian tube (egg pick-up). Since eggs and sperm are placed directly into the ampullary region of the fallopian tube, fertilization and early embryo development occurs in the natural protective environment and the embryo is transported to and enters the uterine cavity in a physiologic manner.

Advantages and Disadvantages of GIFT
This technique can be used as an alternative to IVF for all non-tubal causes of infertility, however, it is not recommended for severe male factor or immunologic infertility when fertilization can be a problem. The main indications for GIFT are young non-tubal factor patients with normal semen analyses. The technique may be particularly applicable to patients with very difficult transcervical intrauterine transfers who have failed IVF cycles with good quality embryos. Disadvantages of GIFT versus IVF include the lack of information regarding fertilization and embryo quality, and the transfer of unfertilized eggs compared to selected embryos.

Tubal Embryo Transfer (TET)

What is Tubal Embryo Transfer?
The transfer of embryos to the fallopian tubes for purposes of achieving a pregnancy. Embryos may be transferred at the fertilized oocyte (zygote) stage in a ZIFT (Zygote Intrafallopian Transfer) procedure or 24 hours later at the 2- to 6- cell stage in a TET procedure.

Advantages and Disadvantages of TET
TET's are mainly used for patients who have a difficult transcervical intrauterine transfer and/or patients who have failed previous IVF and FET cycles due to poor embryo quality. The theoretical advantage of a ZIFT or TET procedure over GIFT or IVF is that fertilization is known to occur, however, embryo development can take place in the natural tubal environment with no possibility of trauma to the endometrial lining caused by a difficult embryo transfer. TET has the advantage over ZIFT of allowing selection of the best quality embryos while giving patients additional time for recovery from the egg aspiration. The majority of TET procedures are performed on male-factor patients with difficult transcervical intrauterine transfers.