Gamete intrafallopian transfer (GIFT) involves a direct transfer of human gametes, sperm and oocytes into the fallopian tubes. Zygote intra-fallopian transfer (ZIFT) involves the transfer of embryos at the pronucleus stage into the fallopian tubes. In in vitro fertilization (IVF), the four- to eight-cell embryo is transferred 48-72 hours after oocyte collection and thus reaches the uterine cavity some two to three days earlier than would occur in a natural cycle. Centres offer comprehensive assisted conception, including IVF, GIFT and ZIFT. IVF-embryo transfer has become acceptable, with improvements in vaginal ultrasound, oocyte retrieval techniques and ambulant care with local sedation and analgesia. In women aged above 40 years, a flexible number of oocytes transferred during GIFT maximizes the chance of achieving singleton pregnancy. ZIFT is indicated for couples who have had repeatedly failed IVF cycles. GIFT/ZIFT is considered for patients who have cervical stenosis or in utero exposure to diethylstilbestrol.