BIRTHS AFTER TRANSCERVICAL GAMETE INTRAFALLOPIAN TRANSFER WITH A FALLOPOSCOPIC DELIVERY SYSTEM

Objective: To evaluate the safety and efficiency of a new delivery sys tem to perform transcervical GIFT. Design: Evaluation of pregnancy rat e (PR), miscarriage rate, ectopic pregnancy rate, and delivery rate. S etting: Institute of Obstetrics and Gynecology, Reproductive Endocrino logy Unit, Infertility and IVF Center. Patient(s): Twenty-five patient s with patent tubes documented by laparoscopy plus falloposcopy. Inter vention(s): Superovulation was induced with GnRH analogue and FSH. Und er laparoscopic control, transcervical cannulation of the tube was don e using a linear everting catheter incorporating direct falloposcopic vision of the tubal lumen. Two lengths of everting catheter (3 and 6 c m) were used providing either isthmic-ampullary or midampullary placem ent of the inoculum. A comparison was done in terms of ease of access and transfer, falloposcopic observations, and PRs between the groups. Main outcome measure(s): Efficacy was established by evaluating the PR , miscarriage rate, ectopic pregnancy rate, and delivery rate. Result( s): The PR was 28% (with no differences between the lengths of evertin g catheters). No ectopic pregnancies occurred. The abortion rate was 2 8.6% and the delivery rate was 20%. Neither tubal perforation nor othe r complications occurred during the procedure. Conclusion(s): Fallopos copic GIFT is safe and efficient and may be a less invasive alternativ e than laparoscopic transfer. (C) 1997 by American Society for Reprodu ctive Medicine.