Comparative study of combined GIFT and IVF-ET with GIFT alone.

Twenty-eight couples with unexplained infertility, or with suboptimal spermatozoa were divided into two groups. One group underwent gamete intra-Fallopian transfer (GIFT), and the other had combined GIFT and in-vitro fertilization--embryo transfer (IVF-ET) (GET). There was a marked difference in pregnancy rates between the two groups, with the pregnancy rate surprisingly being less in the combined GET group; 10% for GET, as compared with 39% for GIFT alone. The results suggest that GIFT and IVF-ET are incompatible. Differences in the pregnancy rates may be explained by limitations in implantation, whereby the embryo-endometrium interaction that allows for implantation and continued embryonic development has a 'single event capacity', and once this interaction is initiated, the 'implantation window' is closed to other embryos that may arrive later in the uterus.