Microinjection and Fallopian Transfer (MIFT) - an effective form of Assisted Reproductive Technology(ART) for the treatment of severe male infertility
IVF Centre
Hong Kong Sanatorium & Hospital
2-4 Village Road, Happy Valley
Hong Kong
url: http://www.ivf.com.hk
email: [email protected]
Dr. Milton Leong
Source: Dawood MY, Am J Obstet Gynecol 1996 Apr;174 (4):1208-17
GIFT vs IVF Result-1
GIFT IVF
Pregnancy per cycle 29.5% 19.8%
Delivery per cycle 19.8% 16.0%
GIFT vs IVF Result -2GIFT vs IVF Result -2
GIFT IVF
Pregnancy per transfer 35.1% 33.3%
Delivery per transfer 29.3% 27.9%
Source:SART Registry, Fertility and Sterility 1996 May;71 (5):798-807
• 1992 1st ICSI Pregnancy report on Lancet by Palermo et. al.
• 1995 TESE-ICSI pregnancy report on Hum Reprod by Siber et. al.
• 1999 1st MIFT case report on J Assist Reprod Genet by Allan et.
al.
Indications of MIFTIndications of MIFT
• Male Factor 83%
• Idiopathic 13%
• Antibodies 1%
• Previously failed IVF 3%
MIFT Jan 98--May 00MIFT Jan 98--May 00
<40 >=40semen Normal AbN Sub-total Normal Abn Sub-totaloocyte retrievals 29 176 205 6 47 53# of oocytes 266 1712 1978 36 309 345MTII 204 1277 1481 74.9% 27 241 268 77.7%MTI 29 191 220 11.1% 4 24 28 8.1%GV 23 183 206 10.4% 1 20 21 6.1%atretic 10 61 71 3.6% 4 24 28 8.1%ICSI'd 216 1321 1537 28 262 290survived 204 1283 1487 96.7% 26 255 281 96.9%2pn of spare eggs 48 354 402 67.0% 1 33 34 53.1%average # of transfer 5 4.8 9.8 4.2 4.4 8.6B-HCG preg 8 27.6% 70 39.8% 78 38.0% 1 16.7% 10 21.3% 11 20.8%ectopic preg 0 0 0 0 0 0On going preg 8 55 63 80.8% 1 4 5 45.5%
multiple preg 4 17 21 26.9% 0 0 0 0% twins 4 10 14 17.9% 0 0 0 0% triplet 0 7 7 9.0% 0 0 0 0% Reduction 4 4 Vanishing sac 3 3average age 35.3 34.5 34.7 41.0 41.3 41.4
Oocytes Retrieval <40
Oocytes Retrieval <40
Cases 205
Oocytes retrieved 1978
MT II 1481 74.9%
MT I 220 11.1%
GV 206 10.4%
Atretic 71 3.6%
Oocyte Retrieval <40
Oocyte Retrieval <40
Semen Normal Abnormal Total
Cases 29 176 205
Oocytes Retrieved 266 1712 1978
MT II 204(76.7) 1277(74.6) 1481(74.9)
MT I 29(10.9) 191(11.2) 220(11.1)
GV 23(8.6) 183(10.7) 206(10.4)
Atretic 10(3.8) 61(3.6) 71(3.6)
Survival and Fertilization Rate<40
Survival and Fertilization Rate<40
ICSI’d oocytes 1537
Survived oocytes 1487 96.7%
Spare oocytes 553
2PN 402 72.7%
Survival & Fertilization Rate <40
Survival & Fertilization Rate <40
Semen Normal Abnormal Total
Cases 29 176 205
ICSI’d oocytes 216 1321 1537
Survived oocytes 204(94.4) 1283(97.1) 1487(96.7)
Spare oocytes 72 481 553
2PN 48(66.7) 354(73.6) 402(72.7)
Age <40 MIFT Pregnancy Rate
Normal sperm Abnormalsperm
Total
B-HCGpregnancy
27.6% 39.8% 38.0%
# of Oocytes MIFT’d vs Multiple Pregnancy <40
MIFT’d oocytes Pg/cases % Twins Triplet
<=2 3/12 25.0% 0 0
3 9/21 42.9% 1 1
4 9/33 27.3% 1 0
5 22/31 71.0% 3 4
6 35/69 50.7% 9 2
# of MT II Retrieved vs Pregnancy <40
# of MT II Retrieved Pregnancy %
<=2 0/3 0%
3 5/8 62.5%
4 1/9 11.1%
5 5/13 38.5%
6 7/23 30.4%
>=7 61/149 40.9%
Oocytes Retrieval>=40
Oocytes Retrieval>=40
Cases 53
Oocytes retrieved 345
MT II 268 77.7%
MT I 28 8.1%
GV 21 6.1%
Atretic 28 8.1%
Oocyte Retrieval >=40
Oocyte Retrieval >=40
Semen Normal Abnormal Total
Cases 6 47 53
Oocytes retrieved 36 309 345
MT II 27(75.0) 241(78.0) 268(77.7)
MT I 4(11.1) 24(7.8) 28(8.1)
GV 1(2.8) 20(6.5) 21(6.1)
Atretic 4(11.1) 24(7.8) 28(8.1)
Survival and Fertilization Rate>=40
Survival and Fertilization Rate>=40
ICSI’d oocytes 290
Survived oocytes 281 96.9%
Spare oocytes 57
2PN 34 59.6%
Survival and Fertilization Rate >=40
Survival and Fertilization Rate >=40
Semen Normal Abnormal Total
Cases 6 47 53
ICSI’d oocytes 28 262 290
Survived oocytes 26(92.9) 255(97.3) 281(96.9)
Spare oocytes 3 54 57
2PN 1(33.3) 33(54.1) 34(53.1)
Age >=40 MIFT Pregnancy Rate
Normal sperm Abnormalsperm
Total
B-HCGPregnancy
16.7% 21.3% 20.8%
# of Oocytes MIFT’d vs Multiple Pregnancy >=40
# of Oocytes MIFT’d vs Multiple Pregnancy >=40
MIFT’d oocytes Pg / cases % Twins Triplet
<=2 0/7 0% 0 0
3 2/11 18.2% 0 0
4 1/8 12.5% 0 0
5 4/11 36.4% 0 0
6 4/16 25.0% 0 0
# of MT II Retrieved vs Pregnancy >=40
# of MTII retrieved Pregnancy %
>=2 1/5 20.0%
3 3/9 33.3%
4 0/4 0%
5 2/8 20%
6 3/7 42.9%
>=7 2/20 10.0%
Age vs Pregnancy
Age Pg / cases %
<36 40/114 35.1%
>=36, <40 39/90 43.3%
>=40 11/53 20.8%
MIFT Multiple Pregnancy <40
MIFT Multiple Pregnancy <40
Total 21/78 26.9%
Twins 14/78 17.9%
Triplet 7/78 9.0%
Reduction 4
Vanishing sac 3
Twins prevalence 14/21 66.7%
• Evaluation l’copy augmented by MIFT
• L’copic minor surgery augmented by MIFT
• Philosophical or religious reasons
MIFT vs ICSI/IVF ResultsJan 98 - May 00
<40 >=40
MIFT 78/205(38.0) 11/53(20.8)
ICSI/IVF 43/157(27.4) 3/33(9.1)
