How much does it cost to have a test tube baby in the United States? Please provide a detailed breakdown of actual expenses and a cost saving strategy

How much does it cost to have a test tube baby in the United States? Attached are real cost details and cost saving strategies - written for families aged 28-45 who are comparing China and the United States. If going to the United States for IVF is compared to a "small entrepreneurship", then "start-up capital" and "hidden costs" are the two curves that determine whether the project can run smoothly. This article uses the latest 2024 prices of first-line reproductive centers, IRS tax returns, insurance claims examples, and accounts of experienced individuals to break down "how much to spend, where to spend, and how to save" into a replicable Excel sheet, allowing you to understand the real financial model of IVF in just 5 minutes. 1、 First, let me give you the conclusion: a summary table to understand the average bill of the "American version test tube" (all amounts are in US dollars, estimated at a 1:7.2 exchange rate, and the Chinese yuan quick calculation formula is attached at the end of the article). Cost categories | Regular self payment range | Median value | Remarks | --------------------------------------- Pre reproductive assessment | 400-900 | 650 | Includes initial diagnosis, B-ultrasound, six hormone tests, and infectious disease screening | 2 Promotion and monitoring | 4000-7000 | 5500 | Drug cost accounts for 60%, B-ultrasound/blood test accounts for 40% | 3 Egg retrieval surgery+anesthesia | 3 500-5 500 | 4 500 | Including operating room, anesthesiologist, embryologist | 4 Laboratory Operations | 5000-9000 | 7000 | Includes ICSI, Embryo Culture, Laser Assisted Hatching | 5 PGT-A (up to 12 blastocysts) | 3 500-6 000 | 4 800 | 250 extra for each additional blastocyst | 6 First year of freezing | 800-1200 | 1000 | Including storage and liquid nitrogen | 7 Single cycle fresh embryo transfer | 3000-4500 | 3800 | Includes transfer surgery and luteal support medication | 8 Pregnancy blood test+early pregnancy ultrasound | 300-600 | 450 | 2 blood β - HCG+1 negative ultrasound | 9 Full cost of medication (after transplantation) | 800-1500 | 1100 | Serotonin+Progesterone Tablets | 10 Institutional management fee | 0-15000 | 8000 | Only appears when third party intervention is needed | 11 Travel/Accommodation/Accompaniment | 3000-8000 | 5500 | Round trip between China and the United States+14 days of accommodation | 12 Unforeseeable reserve fund | 2000-5000 | 3000 | Multiple cycles, emergency treatment, cold delay, etc. | Total (single cycle) | 26 550-63 200 | 44 800 | Approximately 323000 RMB | 2. Cost breakdown: Where does every penny go? 1 Early reproductive assessment - the "registration fee" can also differ by $500. American reproductive centers generally implement a "package system", but the first visit can be purchased separately. Taking INCINTA Fertility Center (California Torrance) as an example, the first visit for a new patient costs $750, including negative ultrasound and consultation; If only blood is drawn at the local LabCorp, an additional $280 can be paid. Compared to RFC (California Corona) in California, which has a first visit fee of $850 but comes with an AMH test as a gift, the price difference is not significant. However, for time sensitive visa customers, the gift program saves half a day of hotel money. two Promoting the use of drugs - the price difference between "direct procurement by American pharmaceutical companies" and "international pharmacies" is 30%. Promoting the use of drugs accounts for 15% -20% of the total cost of a single cycle. The Gonal-F 450 IU pen is priced at $380 at the hospital pharmacy, while the same specification can be shipped directly to Israel or Canada pharmacies for $260, requiring 7-10 days for logistics. Most doctors accept 'purchased drugs', but require that the batch number and cold chain records be sent to the nurse for filing two weeks in advance. Reminder: Customs inspection may result in a 10% delay, so be sure to prepare one emergency pen for backup in the hospital pharmacy. three Should ICSI, blastocyst, and laser hatching all be selected in the laboratory? ICSI (Single Sperm Injection) is considered a "semi standard" in the United States, priced between $1500 and $2200. If the male's sperm is normal, they can request "half ICSI" - only perform ICSI on half of the eggs and perform routine fertilization on the other half, saving about $800. Laser assisted hatching (LAH) for individuals aged 38 and above or FSH> Only at 10 IU/L can there be significant benefits, and young people can skip it and save $600. four PGT-A - How to choose between "charge per piece" and "package price"? Mainstream laboratories such as Orlando based Cooper Genomics offer two modes: A. Package price of $4800, testing ≤ 12 blastocysts; B. Charge per piece, with the first piece costing $1800 and each subsequent piece costing $250. If the number of blastocysts obtained is ≤ 6, choosing option B is more cost-effective; If there are>8 pieces, Plan A is cheaper by an average of over $1000. five Freezing - the renewal trap behind the "first year free" policy. Most clinics offer first-year storage, with a starting price of $600-800 per year for the following year. It is recommended to sign a 3-year contract at once, which can be reduced to $1500 (approximately $500 per year). If planning for future transportation, inquire in advance about the cost of "liquid nitrogen dry transportation", which ranges from $450 to $650 for cross state transportation. six Luteal support after transplantation - the price difference between "Shenuotong" and "PIO oil" is three times. Shenuotong costs about $32 per day, while PIO progesterone oil costs $10 per day, with equivalent effects. Budget sensitive individuals can request a switch, which can save $300 in 14 days. Please note that PIO requires intramuscular injection, and those who are afraid of injections should choose carefully. seven Institutional management fees - under what circumstances will they be incurred? When a third party intervention is required (such as when the uterus does not meet the conditions for pregnancy), US law requires licensed institutions to coordinate medical, legal, insurance, and trust accounts. The management fee ranges from 8000 to 15000 US dollars and will be paid in three installments. If you only take it from yourself, it's completely zero yuan. eight Travel expenses - "off-season airfare+long-term apartment" can save 10000 RMB. During the off-season (February April, September November), direct flights from Cathay Pacific/Delta to Los Angeles in economy class, including taxes, can be as low as 7200 RMB; Airbnb's monthly rent for one bedroom and one living room is $2800, saving 40% compared to hotels. Choose "monthly long-term rental" for car rental, with a daily average of $25, including full insurance. The total 14 day journey can be controlled within 30000 RMB. 3、 Real account book: "Landing expenses" of three families with different needs (converted to RMB, including medical and travel expenses) A. 32 year old couple, hydrosalpinx, self pickup and self conception, single cycle successful medical treatment: 321000 Travel expenses: 29000 Total: 350000 B. 39 year old couple, AMH 0.9， Obtained 6 embryos that passed the testing in two cycles, successfully transplanted for the second time. Medical expenses: 321000+274000 yuan (second cycle saves medication costs). Travel expenses: 58000 yuan for two cycles, totaling 653000 yuan. C. 42 year old single, two cycles of embryo savings+one transplant. Medical expenses: 321000+280000 yuan. Travel expenses: 32000 yuan, totaling 633000 yuan. 4. Insurance and tax refund: Even in the United States, IVF can "restore blood" Fifteen states require mandatory insurance coverage for Massachusetts, New York, New Jersey, Connecticut, Rhode Island, Maryland, Illinois, Delaware, New Hampshire, Maine, California (starting in 2022), Colorado, Texas (some employer plans), and require group insurance to cover infertility diagnosis and treatment. If the spouse's employer is headquartered in the above states, even if you retrieve your eggs in California, you can still apply for compensation. Process: Ask HR to issue an 'Fitness Coverage Letter', and the clinic will directly apply for insurance according to CPT codes 8940 and 8935, usually reporting 50% -80%. two The US Internal Revenue Service allows up to $7750 per year (for families) to be deposited into HSA pre tax accounts. Medications, surgeries, and travel related to IVF (for doctors who require remote treatment) are exempt from taxes. Taking an annual income of $200000 and a tax rate of 32% as an example, fully utilizing HSA can save $2480. three Medical expenses exceeding AGI 7.5% can be tax deductible. If the annual out of pocket medical expenses exceed AGI 7.5%, the excess can be deducted from the federal tax schedule A. For example, if AGI is 150 k and the test tube is self paid for 30 k, a deduction of 150 k x 7.5%=11.25 k can be made. If the deduction exceeds 18.75 k, a tax refund of $4500 will be applied at a 24% tax rate. 5、 Money saving strategy: 12 practical tips from "medicine" to "flight" 1 Medication - Search for coupons on GoodRx 30 days in advance, and Gonal-F 900 IU can be purchased for as low as $280, which is 26% cheaper than hospital pharmacies. -Join the Patient Assistance Program at a pharmaceutical factory, with a household income of 95%. Key: Do not mention the possibility of long-term stay. three Can I bring my partner/parents? Okay. Each companion is required to provide bank statements to prove that they can bear the expenses themselves, in order to avoid suspicion of "possible illegal work". four What should I do if I want to transport the embryos back to China? Chinese receiving hospitals are required to provide an "Embryo Reception Letter", approval from the US CDC, and dry liquid nitrogen transportation, with a cost of $4500 to $6000 and a cycle time of 6-8 weeks. five How to register a baby born in the United States? Obtain a US passport at birth and apply for a travel permit upon returning to China; The settlement requires Birth Certificate Translation Notarization+parent-child identification. If there are differences in political strategies, please call the registered residence Department in advance. 8、 Timeline: A "standard 28 day" D1 flight to the United States for IVF arrived in Los Angeles, stayed in an apartment, purchased D2 for the first visit at the supermarket, formulated a plan, received medication D3-7, and then began to downgrade or directly enter the local monitoring of D8-18 for 3 times. The report was sent to the American nurse D19 and flew to the United States. On the same day, the patient went to the clinic for a follow-up examination D20 and received a night injection D21 to retrieve eggs, anesthesia, and returned to the apartment D22-26 for blastocyst culture 2 hours after surgery. On the 5th day, PGT-A biopsy was performed, D27 fresh embryos were transplanted or rested, and then blood β - HCG was drawn at D28 airport. The subsequent results were notified by email. The RMB quick calculation formula is: Total USD x 7.2+travel expenses 25000=approximate RMB budget. If HSA is used for tax refund, the total 10. Conclusion: Turning "uncertainty" into "calculable" test tubes is never a big gamble, but a project management that can be dismantled. When you write medication costs, flights, exchange rates, and tax benefits into Excel, you will find that the most expensive thing about IVF in the United States is not the price, but the information gap. I hope this detailed list of over 4000 words can help you see the optimal solution between "saving money" and "success rate" before your next expenditure. Wishing you to cross out the 'budget column' soon and bring home the 'fetal heart sounds'.

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