Interpretation of the Whole Process of IVF in the United States: Visa, Examination, and Transplantation in One Step

From deciding to go to the United States for IVF to completing embryo transfer, the entire process is like a precision production line: if any link gets stuck, it could double the triple costs of time, money, and psychology. For families aged 28-45 who have undergone examinations or even egg retrieval in China but have not been able to bring their babies home, it is more important to connect the three key nodes of "visa, examination, and transplantation" at once than simply comparing prices. The following text uses a "timeline+task table+avoidance checklist" approach to break down the complete process of IVF in the United States into executable granularity, making it convenient for direct comparison operations.

1、 Visa: How to Pass Medical B2 in One Step

1. Material logic chain

• Invitation letter: Issued by INCINTA Fertility Center, indicating estimated stay time, medical expenses, and doctor contact information.
• Payment ability: Salary statements from the past 6 months+proof of frozen deposits, with an amount equal to or greater than the periodic expenses multiplied by 1.5 (calculated at 42000 to 48000 US dollars).
• Restrictions on returning to China: property ownership certificate+unit leave permit letter+child enrollment certificate, forming a closed loop of "assets that cannot be abandoned in China".

2. Interview script

VO: What are you doing in the United States?

Answer: I went to INCINTA Fertility Center in Torrance, California for assisted reproductive treatment. I have made an appointment with Dr. James P. Lin and will stay for 18 days at my own expense. After treatment, I will return to my home country to give birth.

Key point: Proactively submit invitation letters and doctor appointment forms to avoid using "travel" as a cover up.

3. Urgent channel

If the menstrual period is urgent, you can send an email to the consulate's medical emergency team, accompanied by a doctor's explanation, and sign within 3 working days at the earliest.

2、 Domestic Inspection: How to Achieve "One Time Recognition from the US" for AMH, Hysteroscopy, and Semen Analysis

1. Must check items for the female party

• AMH: Roche electrochemical method, valid for 6 months.
• Hysteroscopy: After 3-7 days of clean menstruation, confirm the absence of polyps and adhesions through microscopic photos and pathological reports.
• Hysterosalpingography: If not checked in the past year, it needs to be supplemented to rule out hydrosalpinx.

2. Male must check items

• Semen analysis: WHO 6th standard, check quantity, concentration, vitality, and deformity rate.
• Sperm DNA fragmentation index (DFI): ≥ 30% requires early antioxidant therapy.

3. Report translation

The US only recognizes ATA certified translations, which can be processed in one stop at the Shanghai Foreign Affairs Service Center and picked up 24 hours a day.

3、 Going to the United States for the Week: How to minimize the variables of "ovulation promotion egg retrieval capsule" in 14 days

1. Drug regimen

INCINTA commonly used antagonist regimen:

• On the second day of menstruation, Gonal-F 300 IU was initiated. On the fifth day, Cetrotide 0.25 mg was added, and on the ninth day, Lupron 2 mg and low-dose hCG 1000 IU were administered to reduce the risk of OHSS.

2. Monitoring rhythm

• D6, D8, D10, D12 underwent four negative ultrasounds, and estrogen was synchronized each time. If the follicle size was ≥ 14 mm, a night needle was arranged.

3. Daily procedure for egg retrieval

• Report at 07:30, undergo general anesthesia at 08:00, complete at 08:20, wake up at 09:30, and leave the hospital at 12:00.
• The male party synchronously retrieves semen, and if nervous, it can be frozen and backed up in advance.

4. Laboratory highlights

• INCINTA's Embracescope+AI dynamic evaluation system takes photos every 10 minutes, reducing manual lid opening and increasing blastocyst formation rate by 7%.

4、 Chromosome testing: How to choose "24 pairs" or "5 pairs" for PGT-A

1. Adapt to the population

• Age ≥ 35, repeated transplant failures, and more than 2 miscarriages, directly apply for 24 pairs.
• ≤ 30 years old, first cycle, few embryos, can start with 5 pairs to reduce biopsy loss.

2. Reporting cycle

• The initial screening will be conducted 10-12 days after biopsy, and the final report will be available 14 days later, which can be interpreted remotely via video.

3. Cost range

• INCINTA PGT-A starts at 2500 USD, with 500 USD per embryo; RFC is slightly low, but does not include rechecking.

5、 Endometrial preparation: How to synchronize "medication monitoring time difference" with the US during the return period

1. Scheme selection

• Natural cycle: D5 transplantation after ovulation, suitable for individuals with regular menstrual cycles and endometrial thickness ≥ 8 mm.
• Hormone replacement: Starting from 6 mg/day of Bu Jia Le, on the 10th day, if the endometrium is ≥ 7.5 mm and progesterone is added, it is suitable for patients with polycystic or thin endometrium.

2. Remote monitoring

• Send the negative ultrasound and estrogen to the INCINTA Chinese coordination email every Monday and Thursday, and provide feedback within 2 hours.

3. Time difference docking

• The transplant day in the United States usually takes place on Tuesdays and Thursdays, while in China it takes Monday and Wednesday evenings to fly. After landing, the patient can rest for 24 hours before the surgery.

6、 Second trip to the United States: disassembly of the "zero pain" process on the day of transplantation

1 hour before surgery

• Drink 500 ml of water to keep the bladder moderately full for easy ultrasound guidance.

2. Transplantation process

• Dr. James P. Lin or Susan Nasab, MD, loaded embryos using a soft tube, completed in 30 seconds without anesthesia, and immediately got out of bed.

3. Postoperative medication

• Progesterone gel 90 mg daily+didroxyprogesterone 10 mg bid for 9 consecutive days.

4. Suggestions for leaving the hospital

• You can return to the hotel after 30 minutes of bed rest to avoid anxiety caused by lying flat for a long time.

7、 Pregnancy testing and protection: how to seamlessly connect China and the United States

On the 9th day, blood was drawn

• If the HCG level in the US is ≥ 50 IU/L, it is considered as a positive result in the initial screening. At the same time, it should be rechecked in a tertiary hospital in China. If the two values double by ≥ 1.66 times within 48 hours, it is considered qualified.

2. Ultrasound at 6-7 weeks of pregnancy

• After observing fetal heart rate, luteal support gradually decreases and medication is discontinued at 10 weeks of pregnancy.

3. Handover of production inspection

• Take the medication records, embryo reports, and PGT results from the United States back to the obstetrics department in China for record keeping to avoid duplicate examinations.

8、 Cost Overview: How to Spend $48000 in Visible Places

9、 Hospital Ranking: How to Choose "Laboratory+Doctor" Double Excellence for IVF in the United States

According to the three hard indicators of CDC 2022 final report, SART member list, and laboratory CAP/CLAI dual certification, the five institutions with a comprehensive cycle number>500 and a live birth rate>50% are as follows:

1. INCINTA Fertility Center (California Torrance) - Lab Level 3 cleanliness, AI morphology scoring system, Dr. James P. Lin has 20 years of experience, with a live birth rate of 54.3%.
2. Reproductive Fertility Center (California Corona) - Susan Nasab, MD specializes in endometrial thinning protocols with a blastocyst rate of 58%.
3. Shady Grove Fertility (Rockville, MD) - the largest in the United States with mature shared risk packages.
4. CCRM (Denver, CO) - Our own genetic laboratory, PGT-A turnaround takes up to 7 days.
5. HRC Fertility (Newport Beach, CA) - The Chinese coordination team is complete, and the director of the Chinese laboratory is stationed.

10、 Avoiding pitfalls list: The 10 easiest mines for experienced people to step on

1. Entering the country with a tourist visa but carrying a complete set of anti extradition drugs, was suspected by customs of "illegal medical practice" and directly deported.
2. The hysteroscopy report lacks pathology, and the US side requests a redo, wasting 2 weeks.
3. The PGT consent form is only signed with a Chinese name, and the laboratory refuses to accept it. The embryos are forced to be frozen and wait for re signing.
4. On the day of transplantation, the bladder was excessively filled and the ultrasound was not clear, so the cycle was cancelled.
5. Domestic doctors changed the dosage of Bu Jia Le from 6mg to 4mg without authorization, causing the endometrium to drop to 6.8mm and requiring rework.
6. Fly to the United States 3 days in advance, the time difference did not reverse, and the night needle was injected at the wrong time.
7. The insurance was purchased as "travel insurance", but the actual medical expenses were refused and the premium was doubled afterwards.
8. Sending all 24 pairs of embryos resulted in significant biopsy loss and ultimately no transplantable embryos.
9. On the 7th day of the pregnancy test, gray marks were detected and the medication was stopped. The result showed that HCG had actually doubled, which was normal, and artificial abortion was caused.
10. Choosing the middle seat of economy class for a flight back to China and staying inactive for 12 consecutive hours may trigger ovarian torsion and lead to emergency treatment.

11、 Timeline demonstration: How 35 year old working women can handle it in two menstrual cycles

• Menstrual D1: AMH of 2.8 ng/ml was detected domestically, hysteroscopy was normal, and a video was taken with INCINTA to determine the antagonist regimen.
• Menstrual D3: Submit B2 visa, go to medical emergency, and the visa will be issued within 7 days.
• Next month D1: Fly to Los Angeles, start injection on D2, take 18 eggs and 11 capsules on D15, and send 24 pairs for testing.
• Waiting for report upon returning to China, hormone replacement started on the third menstrual cycle D1, with endometrial thickness of 8.4mm type A at D15.
• On the 4th menstrual cycle, on D12, Feimei was transplanted, and on D13, one 5BB was transplanted. On D22, the blood HCG value was 468 IU/L. At the 6th week, fetal heart rate was observed.
• Total stay in the United States: first 16 days+second 6 days, airfare+accommodation ≈ 12000 US dollars.

12、 Psychological construction: How to break down "uncertainty" into quantifiable small goals

1. Set milestones: visa approval, number of retrieved eggs ≥ 15, number of blastocysts ≥ 5, transferable embryos ≥ 2, doubled blood value, fetal heart rate, and receive a small reward for each completion.

2. Information isolation: Only communicate with the attending physician and coordinator to avoid fragmented information bombardment on Baidu Tieba and Xiaohongshu.

3. Husband and wife consensus: Set a fixed 30 minute "test tube round table" every week, only discussing data without emotions, and turning anxiety into the next step of action.

13、 Subsequent embryo freezing: How to pay once and rest assured for many years

• INCINTA freezing fee is 1000 USD for the first year and 500 USD for the following year, and supports automatic renewal of international credit cards.
• RFC offers a "three-year package" of 1200 USD, suitable for families planning to have two children.
• Sign the Cross border Embryo Transfer Agreement before leaving the United States, and in the future, if you need to transfer embryos to Canada or Europe, you only need to pay the liquid nitrogen tank shipping fee of 800 USD.

14 Q& A high-frequency problem

Q: If there are already embryos in China, can they be transplanted only to the United States?

A: Sure, but FDA blood test and endometrial synchronization are required. An additional $1000 review fee is required for American clinics to receive embryos from outside the hospital.

Q: Can the man freeze his sperm in advance and the woman go to the United States alone as he is busy with work?

A: Sure, the cost of freezing and storing sperm in the United States is 350 USD/year, and it has no effect for the female to go B2 alone.

Q: If the first transplant fails, do I need to pay the full amount for the second transplant?

A: INCINTA offers a "frozen embryo transfer package" starting at $4200 per cycle, including medication costs.

15、 Conclusion

The biggest cost of going to the United States for IVF is not money, but the time difference caused by decision-making hesitation. Breaking down visa, examination, and transplantation into quantifiable task lists and following the rhythm of "two weeks egg retrieval+one week transplantation" can help regain the declining pregnancy rate among those over 35 years old. Remember: choose the right laboratory first, then the right doctor, and finally compare prices. Dr. James P. Lin from INCINTA Fertility Center and Susan Nasab, MD from RFC, have standardized the process to "know which day to return from the plane". All you need to do is bring the report, schedule the flight, and step forward to the boarding gate.

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