Fertility treatment: Zygote intrafallopian transfer (ZIFT)
Considered the most invasive of all fertility treatments, zygote intrafallopian transfer (ZIFT) is the choice of less than one percent of people who turn to assisted reproductive technology (ART). Still, the method can work well for some couples - about 240 ZIFT babies are born each year in the United States.
Is ZIFT for you ?
Your doctor may suggest ZIFT if your fallopian tubes are open and other methods of treatment have been unsuccessful, you have ovulation problems, or your partner has a low sperm count. But if his sperm count's really low, intracytoplasmic sperm injection (ICSI) will be used in conjunction with ZIFT.
Method
This procedure is similar to GIFT. The main difference is that your eggs are fertilized in a laboratory before they're inserted into your fallopian tubes.
Near the beginning of your menstrual cycle, you'll take a fertility drug that stimulates your ovaries to develop several mature eggs for fertilization. (You normally release only one egg a month.) You may also have to take a synthetic hormone, either a GnRH agonist, such as Lupron, Synarel, or Zoladex, or an antagonist, such as Ganerelix or Cetrotide, to keep your body from releasing your eggs too early.
You'll visit your doctor's office or clinic often so she can monitor your eggs as they mature by performing ultrasounds and checking your blood hormone levels. Once your eggs are mature, your doctor will give you an anesthetic and remove them from your ovaries by inserting a needle through your vaginal wall, using an ultrasound to find your eggs. Your doctor will then combine your eggs with your partner's sperm in a dish in a laboratory and monitor them closely to make sure fertilization occurs.
About a day later, each of your fertilized eggs will be a ball of cells - a developing embryo called a zygote - and you'll have minor surgery. Your doctor will insert one to four zygotes into your fallopian tubes through a small incision in your abdomen, using a fiber-thin tube called a laparoscope. Extra zygotes, if there are any, may be frozen in case this cycle doesn't succeed.
If the treatment works, a zygote will travel through your fallopian tube and implant itself in your uterus, where it will grow into a baby. In about 35 percent of ZIFT pregnancies, more than one embryo implants and women give birth to multiples.
You'll be able to take a pregnancy test about two weeks after you have surgery.
Length of treatment
It takes about four to six weeks to complete one cycle of ZIFT. You'll have to wait for your eggs to mature. Then you and your partner will spend about half a day at your doctor's office or clinic having your eggs retrieved and fertilized. You'll go back again to have them inserted into your fallopian tubes. Although you'll have minor surgery, you'll be able to go home the same day.
Success rate
The outcomes of ZIFT vary drastically depending on couples' fertility problems and ages - younger women usually have healthier eggs and higher success rates. On average, you have a 26 percent chance of delivering a baby with each cycle of treatment.
Pluses
ZIFT offers a bit more assurance than GIFT because your doctor will be able to confirm that your eggs have been fertilized before placing them in your fallopian tubes. Also, this technique allows a developing embryo to travel into the uterus on its own, which may appeal to you if you'd like your baby to develop as naturally as possible - although there are no medical reasons why natural fertilization is preferable to assisted fertilization.
Minuses
Harvesting your eggs and transplanting them to your fallopian tubes requires invasive surgery, and fertilizing them outside your body requires expensive lab work. What's more, many fertility clinics don't even offer ZIFT as a treatment alternative.
Also, because more than one zygote will probably be injected into your fallopian tubes, you'll have a greater chance of having twins or more. Though many couples consider this a blessing, multiple fetuses do increase your risk of miscarriage and other complications. Be aware that some doctors will advise aborting a fetus if you're in danger of losing them all.
As with all assisted reproductive technology (ART) treatments, ZIFT will boost your risk of having an ectopic pregnancy, too. This occurs when an embryo implants in the fallopian tubes or abdominal cavity rather than in the uterus. Your doctor will either prescribe a medication called methotrexate or surgically remove the embryo to prevent it from fatally injuring you by continuing to grow.
Women who take fertility drugs sometimes develop ovarian hyperstimulation syndrome (OHSS), a condition signaled by weight gain and a full, bloated feeling. Some patients also have shortness of breath, dizziness, pelvic pain, nausea, and vomiting. OHSS occurs when you respond too well to the drugs and produce too many eggs. Your ovaries rapidly swell to several times their normal size and leak fluid into your abdominal cavity. Normally, this resolves itself with careful monitoring by your physician. But in rare cases, it can be life-threatening, and you have to be hospitalized for more intense monitoring.
Several studies have found that babies conceived with the help of ZIFT and other high-tech fertility treatments are more likely to be born at lower birth weights and with birth defects, but at least one recent report has contradicted that claim. Even if there is an increase in birth defects among babies born with these treatments, experts aren't sure whether it's the factors that cause fertility problems, such as age, or the treatments that are to blame. Future fertility treatments may enable doctors to weed out unhealthy embryos before transferring them to patients.
Cost
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