REFINEMENTS IN THE METHODOLOGY OF INJECTION FOR TRANSVAGINAL GAMETE INTRAFALLOPIAN TRANSFER

Eighty-seven volunteer patients with non-tubal infertility initially i ntending to undergo gamete intra-Fallopian tube transfer (GIFT) via a transabdominal route were re-scheduled for ultrasound-guided transvagi nal GIFT which was performed using a Jansen-Anderson tubal transfer se t. Emphasis was placed on (i) definite ultrasound confirmation of the transfer catheter within the Fallopian tube, (ii) low transfer volumes (50 mu l), (iii) high sperm transfer densities and (iv) slow injectio n of gametes. Transvaginal Fallopian tube catheterization was possible in 83 patients (95.4%). Twenty-three of 83 (27.7%) patients conceived (clinical pregnancy). The viable ongoing pregnancy rate was 20.5%. Th ese results compare favourably to those previously reported for both t ransvaginal and transabdominal GIFT. This study suggested that the flu id dynamics of gamete injection following transvaginal Fallopian tube catheterization are different to those following transabdominal method s. Further study is necessary to define the optimal methodology for tr ansvaginal GIFT and to enhance the ability of the procedure to produce pregnancy rates comparable to transabdominal GIFT.