What is GIFT (Gamete Intrafallopian Transfer)? What are the steps involved? How is it different from In Vitro Fertilization (IVF)?

In the past, infertility treatment was called GIFT (Gamete Intrafallopian Transfer), which was considered one of the most advanced methods and became very popular. However, today it has evolved into IVF (In Vitro Fertilization) and ICSI (Intracytoplasmic Sperm Injection). GIFT and IVF have different procedures, and many people may wonder how GIFT works, which method has a higher success rate, or how they differ from each other.

GIFT (Gamete Intrafallopian Transfer) is a procedure in which the patient is put under general anesthesia and undergoes laparoscopic surgery through three small incisions in the abdomen. The eggs and sperm are then placed directly into the fallopian tube, allowing fertilization to occur naturally. Once fertilization is complete, the resulting embryo develops and moves into the uterus for implantation, eventually leading to pregnancy.

The process begins with ovarian stimulation using medications, which may be administered orally, via injection, nasal spray, or other methods. The doctor will determine the appropriate treatment for each individual, and the stimulation process typically takes 7-10 days.

An ultrasound is performed to monitor the ovarian response. Once the follicles reach the desired size and quantity, and hormone levels increase to an optimal range, the doctor will trigger ovulation.

After 34-36 hours of ovulation induction, the eggs are retrieved using one of two methods:

1. Through the abdominal wall – A laparoscope is used to examine the ovaries clearly, and a needle is inserted directly to aspirate the eggs.

2. Through the vaginal wall – An ultrasound-guided needle is used to retrieve the eggs via the vaginal canal.

Both methods require abdominal incisions to allow instruments to retrieve the eggs and return them, along with sperm, into the fallopian tubes.

The transfer of eggs and sperm into the fallopian tubes is typically performed using laparoscopy. The selected eggs are drawn into a specialized catheter designed for gamete transfer and placed into the fallopian tubes along with sperm, allowing natural fertilization to occur.

The doctor will then administer hormones to support embryo implantation. Pregnancy is confirmed by measuring hCG hormone levels in the blood, which can be tested approximately 12 days after the transfer.

• Women with endometriosis but at least one normal fallopian tube

• Women with ovulation problems, such as anovulation or lack of egg production

• Women with reproductive system issues

• Men with low sperm count or weak sperm motility

• Couples experiencing unexplained infertility

When patients have all the information, they often wonder how GIFT differs from IVF.

GIFT (Gamete Intrafallopian Transfer) is an assisted reproductive technology that involves a surgical procedure to place both sperm and eggs directly into the fallopian tube, allowing fertilization to occur naturally inside the body. However, this method is rarely used today.

In contrast, In Vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI) are more advanced fertility treatments that do not require abdominal surgery. Instead, eggs are retrieved using specialized equipment through the vaginal canal, eliminating the need for abdominal incisions. The eggs and sperm are then fertilized outside the body in a laboratory setting.

The embryos are cultured until they reach the blastocyst stage (day 5) before being transferred into the uterus for implantation. Unlike GIFT, IVF/ICSI does not require a recovery period, making it a preferred method in modern fertility treatments.

This method is similar to natural intercourse, but the doctor will prescribe medication to make the eggs grow larger and in greater numbers. Additionally, sperm will be selected for quality, with only the strongest sperm being injected into the woman's uterus to increase the chances of the sperm reaching the egg.

The success rate of this method is 10-15%.

It is a method that has developed from the previous GIFT technique, but with a higher success rate and without the need for abdominal surgery. The process involves injecting hormones to stimulate egg production for 10-12 days, then extracting the eggs and fertilizing them with sperm in the laboratory. The embryos are cultured until they are ready and then transferred into the woman's uterus to grow and develop into a pregnancy.

The success rate for this method is 70-80%.

If we talk about the cost of GIFT (Gamete Intrafallopian Transfer) nowadays, it is quite rare. Going back to the past, it would cost around 300,000-400,000 baht, which, when compared to the currency at the time, was considered a high-cost procedure with a low success rate. For this reason, GIFT is no longer commonly used for infertility treatment today. However, many Thai people still use the term "doing GIFT" or still search for information about how much GIFT costs.

Can same-sex women undergo GIFT?
In Thailand, same-sex couples are currently not allowed to undergo GIFT or IVF due to legal restrictions. GIFT or IVF procedures require official marriage documentation, and Thailand does not yet recognize same-sex marriages. Therefore, same-sex couples, whether female or male, cannot undergo GIFT or IVF under current laws.

Can GIFT be done without a husband?
In Thailand, it is not legally allowed to undergo GIFT without a husband. The law permits fertility treatments only for legally married couples. However, in some other countries, women without a husband can undergo fertility treatments like IVF using sperm from a sperm bank. The process is similar to regular IVF, but the sperm is anonymously provided, and the eggs are stimulated and fertilized as part of the IVF procedure. In the future, as laws may evolve, it is possible that fertility treatments like GIFT may become available without the need for a husband.

How does the cost of GIFT compare to ICSI?
In the past, there were significant limitations on fertility treatments in Thailand, with very few places offering GIFT, which required abdominal surgery. Due to the advanced equipment needed, GIFT treatments were very expensive, with costs starting at around 500,000 baht. At that time, it was considered one of the best options available.

Today, however, fertility treatments have advanced, and IVF, with higher success rates, has become more common. The cost of IVF is still relatively high, but it is significantly cheaper than GIFT, starting at around 100,000 to 200,000 baht. IVF also offers higher success rates and better safety compared to GIFT.

How much does it cost to do GIFT if you want twins?

Normally, in fertility treatments, there is a chance of having twins either intentionally or naturally. However, when it comes to the cost, there is generally no additional charge for expecting twins because the success of having twins cannot be guaranteed. This is to manage the expectations of patients.