Fertility Treatments: IVF and ICSI

Artificial insemination includes the incubation of cells in appropriate conditions using specific incubators.

In vitro fertilization (IVF) is a process of fertilization where an egg is combined with sperm outside the body, in vitro (“in glass”). This is done in special laboratory environment. To increase the chance of successful in vitro fertilization, a woman’s ovaries are stimulated in in order to collect more mature oocytes (10-15) than in natural cycle. The oocytes are collected during a short procedure (~ 15 minutes), which is called oocyte pick-up. Male partner gives semen sample in the clinic on the same day of the procedure.


In case of the classical IVF (in vitro fertilization) method, in the lab, the retrieved eggs are combined with sperm (from either the intended father or from a sperm donor.) The egg and sperm are put together in a petri dish, where a sperm cell will fertilize an egg cell. The dish is cultured in an incubator with body-like conditions. After 16-18 hours, the fertilization of the eggs is checked and correctly fertilized eggs are further cultured, so that the embryos can develop. Embryo development is monitored in the laboratory for 2-6 days.


ICSI (intracytoplasmic sperm injection) is a method of in vitro fertilization in which a single healthy sperm is selected under a microscope and inserted directly into the cytoplasm of an oocyte using a micropipette. The ICSI method is usually used in cases of male infertility or if the previous IVF method has not given the desired result. The ICSI method is also used, if a woman’s oocytes have been frozen before (see cryopreservation). Further development and monitoring of embryos is performed similarly to the IVF method.

Stages of in vitro fertilization:

  • Consultation, baseline studies, bloodwork, analysis, ovarian stimulation.
  • Egg retrieval and sperm sample given
  • Fertilization (IVF / ICSI)
  • Embryo culture (2-6 days)
  • Embryo (s) transfer
  • Pregnancy test

Embryo Transfer


Gynaecologists appointment

Fertility testing

The day of embryo transfer depends on the development and number of embryos. The embryologist selects best quality embryo (s) for transplantation. In Estonia, it is allowed to transplant up to 3 embryos, but it is usually recommended to transplant 1 embryo in order to avoid the possible risks associated with multiple pregnancies. If there is a surplus of embryos, intended parents have an option to freeze good quality embryos for future IVF treatments..

Detection of pregnancy

To conceive, the embryo must attach to the inner surface of the woman’s uterus (or endometrium. Two weeks after embryo transfer, the blood test (hCG) shows whether the embryo has nested. Clinical pregnancy can be detected  6 weeks after transplantation.

The success of in vitro fertilization is individual and depends on the causes of infertility. On average, about 30% of procedures succeed.

ICSI means the injection of an oocyte in a clean laboratory under a specific microscope.

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