Right ART protocol?
3 Replies
carriek - February 24

Dr. Jacobs,

I am 31, blocked right fallopian tube on hsg, post coital test and endo biopsy good, u/s showed good follicle at O, all b/w is normal (no exposure to STD's to explain blockage). RE suspects endometriosis or some other adhesions based on my history of constant pelvic pain and how debilitating my AF is. DH had low volume & morphology on 3 tests.
RE has recommended doing ZIFT. In the CDC report it shows that his center does the highest percentage of ZIFT procedures when compared to other centers across the country. (79% vs 11% for the next highest) They say it is because they have very good success with ZIFT, and they do have the highest success rate in the state. My OBGYN recommended I get a second opinion, but the center she referred me to does IVF on 100% of their patients, so I know they will just tell me to do IVF.
I LOVE my RE, I am just concerned that I am being lumped in with the majority and I am questioning what is best for my situation. RE says he would like to the laparoscopy to see if he can diagnose what the actual cause of infertility is, even though if I do have endo nothing will be done about it. The embryo transfer will be done that day IF my left tube is, in fact, open.
I am confident that whatever ART procedure I decide to do, it will work! I just wonder if there really a point of diagnosing endo if nothing is going to be done to try to clear it up. (RE does not want me to do anything about the endo before I get pregnant because healing/scarring could further compromise fertility.)
I think it’s worth going through the most invasive of all ART procedures simply because of RE’s success rate with it, but does the ZIFT protocol sound reasonable to you? I guess I question my ability to be objective in this situation.
Thank you so much for being here for all of us!


B. Jacobs, M. D. - February 25

ZIFT is a good protocol if the embryo lab cannot reliably grow embryos. Human embryos require extremely demanding conditios, and apparently not all labs are able to achieve the level of quality control necessary. We have not performed a ZIFT procedure in many years.
Good luck.


carriek - February 26

So are you saying the only good reason to do ZIFT is if the lab is sub-par?


B. Jacobs, M. D. - February 26

Given the quality of the lab we have, we do not see a benefit to ZIFT. It requires your having a second anesthetic the day after retrieval.
Good luck.



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