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Human Reproduction, Vol. 5, No. 4, pp. 434-438, 1990
© 1990 European Society of Human Reproduction and Embryology

other

Gamete intra-Fallopian transfer in non-endometriotic pelvic adhesions

Talha Al-Shawaf1, Michael Ah-Moye, William Fiamanya, Bill Smith and Ian Craft

Fertility and IVF Unit, Humana Hospital Wellington Wellington Place, London NW8 9LE, UK

Correspondence: 1To whom correspondence should be addressed

This report presents our experience with gamete intra-Fallopian transfer (GIFT) in cases with non-endometriotic pelvic adhesions. Two-hundred-and-eight GIFT attempts, where pelvic adhesions were identified laparoscopically in patients with no previous history of endometriosis, were subdivided into two groups: (i) post-surgical (n = 134) and (ii) non-surgical (n = 74). The extent of the adhesions was further classified according to the American Fertility Society (AFS) classification system. The overall clinical pregnancy rate was 39.4% (82 out of 208 attempts). There was no significant difference in the clinical pregnancy rate per attempt between the surgical (38.8%) and the non-surgical (40.5%) groups. A gradual, but not significant decline in the pregnancy rate was noticed from adhesion Stages I to III, but Stage IV had a significantly lower pregnancy rate (22.7%) than Stage I (47.4%). The intra-uterine pregnancy rate was observed to be higher, but not significantly, in the nonsurgical (37.8%) than in the surgical (29.1%) cases. The overall ectopic pregnancy rate was 7.2% per attempt and 18.3% per clinical pregnancy. In the post-surgical group, the ectopic pregnancy rate per pregnancy was 3.5 times that in the non-surgical(23.2% versus 6.5%, respectively), and it was significantly higher in Stage IV (40%; two out of five pregnancies) than in Stage I adhesions (11.1%; three out of 27 pregnancies). In cases with a history of tubal surgery, the ectopic pregnancy rate was 33.3% (10 out of 30 pregnancies). Our results indicate that GIFT can offer a successful treatment option for selected cases with non-endometriotic pelvic adhesions.

Key words: adhesions/GIFT/outcome


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