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Artificial Intelligence in Health AI in embryo selection for ART

advancing age, health limitations, and adoption barriers, IVF, and embryo freezing. GIFT has an improved version
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can contribute to broader acceptance and responsible known as “New GIFT,” which has evolved from its earlier
practices. Legal and ethical concerns about surrogacy form referred to as “Old GIFT.” The New GIFT approach
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differ considerably among nations. Countries such as is more effective than the Old GIFT, with the formation
the USA, France, Germany, and Austria predominantly of pregnancy primarily dependent on sperm motility and
impose restrictions on surrogacy, whereas nations such oocyte count. The New GIFT approach, which involves
as India, Russia, and Kazakhstan hold more permissive preincubation of oocytes, has a lower abortion rate (19%)
legislation. Ethical discussions frequently classify and a higher pregnancy rate (37% each cycle and 42%
nations as either advocates or adversaries, highlighting per patient) than the Old GIFT method (24% per cycle,
concerns over the possible exploitation of women in poor 29% per ovum pick-up, and 22% abortion rate). It is more
economic circumstances. Moreover, surrogacy prompts effective overall because it highlights the significance of
concerns regarding parental rights and acknowledgment. mature oocytes and sperm motility, as well as benefits from
The identification of the legal mother – be it genetic or improved luteal support. 60,61
gestational – differs by jurisdiction, further complicating
the legal status of both the child and the surrogate. Certain 3.7.5. Zygote intrafallopian transfer (ZIFT)
nations, such as Israel, have established extensive legal ZIFT combines the natural environment of the fallopian
systems that may function as a model for international tubes with IVF. In this method, zygotes are placed into
standards. Furthermore, the commercialization of fallopian tubes 24 h after fertilization in the lab following
surrogacy engenders ethical dilemmas about treating ICSI. The transfer is carried out using a catheter during
reproduction as a commercial process, possibly abusing laparoscopy, allowing the zygotes to travel through the
women in economically precarious circumstances. In fallopian tubes naturally to the uterus. ZIFT is typically
addition, ethical issues focus on the moral repercussions considered by patients with fallopian tube issues or those
of surrogacy as a type of contemporary slavery. 54,55 The role seeking a more natural method for embryo implantation.
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of the gestational surrogate is typically underestimated, A 2-year study reported that ZIFT has a 40.4% clinical
which can lead to ethical oversights, such as those found pregnancy rate and a delivery/ongoing rate of 34.2%.
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in adoption and donor-assisted conception. Therefore, While IVF-ET has the highest cumulative take-home
understanding the gestational connection is essential for baby and pregnancy rates for treating male infertility,
ensuring ethical surrogacy activities. On the other hand, both GIFT and ZIFT show comparable rates of pregnancy
the absence of international agreement on surrogacy but are associated with higher rates of miscarriage. In
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legislation has led to the phenomenon of “surrogacy IVF-ET cycles, ZIFT has proven particularly beneficial
tourism,” where individuals pursue surrogacy services in for patients experiencing repeated implantation failure.
nations with more advantageous regulations. This situation Research indicates that ZIFT considerably increases
underscores the urgent need for internationally recognized the likelihood of pregnancy and implantation in these
standards to safeguard the rights and well-being of all individuals compared to further IVF-ET cycles. For
parties involved. 55,56 example, patients with repeated implantation failures had
pregnancy rates of 34.2% with ZIFT compared to 17.1%
3.7.4. Gamete intrafallopian transfer (GIFT) with IVF-ET. 64,65 Despite these advantages, ZIFT is more
GIFT is used to address infertility or genetic issues that may invasive than conventional IVF-ET due to the requirement
prevent spontaneous conception. Through GIFT, sperm and of laparoscopy. Moreover, studies have shown that,
eggs are inserted into the fallopian tubes, allowing internal especially in cases involving male-factor infertility or non-
fertilization. Along with other treatments, including IVF tubal infertility, the added complexity of ZIFT does not
and ET, GIFT is a part of the ART spectrum. Several always result in improved outcomes. 66,67
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variables, including the quality of gametes and the physical
and psychological conditions in which the operation is 3.7.6. Artificial insemination
conducted, affect the outcomes of GIFT. Couples seeking Artificial insemination involves the use of a syringe and an
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reproductive treatment still have the option of GIFT, even artificial insemination catheter to inject semen into a woman’s
though it is less prevalent than IVF and ET. For women uterus. This medical treatment is performed in conjunction
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with healthy fallopian tubes, GIFT is an easier and more with homologous insemination, particularly in cases of
effective assisted conception approach that provides higher oligospermia or when sexual intercourse becomes difficult. In
successful rates than IVF. It is also an effective treatment more complicated situations, donor sperm can be surgically
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for non-tubal infertility, with a 32% rate of continued inserted into a female’s oviduct through laparoscopic
pregnancy and options for ovum donation, diagnostic surgery; however, this method is more invasive, costly, and

Volume 2 Issue 3 (2025) 11 https://doi.org/10.36922/aih.7170