In recent years, the topic of in vitro fertilization in the United States has continued to heat up among middle-class families in China. From sharing experiences on social media to expert lectures at high-end medical salons offline, 'Going to the United States for IVF' seems to have moved from the celebrity circle to the general high net worth population. The latest annual report on assisted reproductive technology released by the Centers for Disease Control and Prevention (CDC) shows that the number of cycles completed by Chinese patients in the United States has maintained double-digit growth for five consecutive years, with California, Nevada, and New York on the West Coast having the highest proportion. Why can clinics across the ocean become a common choice for many families? We interviewed several reproductive endocrinologists, embryologists, and cross-border medical consultants with both Chinese and American practicing qualifications, and summarized the following five core advantages to help readers fully understand the medical logic, legal framework, and service chain behind this "warm wave to the United States".
List of Five Core Advantages of IVF in the United States
| Dimension |
Current situation in China |
Highlights of Going to the United States |
key data |
typical scenario |
| 1. Depth of Medical Technology |
Most centers still focus on Day-3 fresh embryo transfer, with a blastocyst culture rate of about 45-55% and a PGT penetration rate of less than 20% |
Mainstream clinics commonly use Day-5/6 blastocyst culture, total time difference imaging (TLM), and artificial intelligence embryo scoring, with a PGT-A detection rate of>75% |
The average clinical pregnancy rate per transplant in the United States is 48.7%, with 60.1% for those under 35 years old (CDC 2023) |
Families with advanced age and repeated implant failures have reduced their miscarriage rate from 35% to less than 10% through whole chromosome screening |
| 2. Laboratory hardware |
The cleanliness of the embryo room in the regional center is mostly at the level of thousands or tens of thousands, and 2-3 three gas incubators are shared |
Head clinic independent hundred level laminar flow+multiple three gas/low oxygen incubators+laser assisted incubation+freezing using vitrification rapid cooling (>10000 ℃/min) |
Recovery survival rate ≥ 98%, embryonic chromosome integrity loss rate<1% |
Patients with endometritis who require delayed transplantation should have their embryos frozen and processed in the uterine cavity before undergoing resuscitation and transplantation |
| 3. Expert resource density |
On average, each chief physician in the reproductive center of a tertiary hospital receives over 3000 cases per year, with a face-to-face consultation time of 5-8 minutes |
The average annual cycle of doctors certified by the Reproductive Endocrinology and Infertility Institute (REI) in the United States | According to the official website of the American Board of Obstetrics and Gynecology (ABOG), there are only over 1200 REI certified physicians, indicating high scarcity |
Patients with complex endocrine backgrounds (pituitary tumors, thyroid cancer after surgery) will receive multidisciplinary consultations from endocrinology, reproductive health, and anesthesia departments |
| 4. Legal and Ethical Framework |
Commercial third party assisted reproduction is prohibited, and there is a gray area in the ownership of embryo disposal rights |
California and other states have complete case law that allows and protects expectant parents to have full custody from early pregnancy; Clear agreements for embryo ownership, transportation, and destruction |
California Family Code § 7960-7962 has explicit provisions regarding the rights and obligations of "intended parents", with a success rate of over 95% in litigation cases |
One spouse needs to undergo radiotherapy and chemotherapy, and can freeze the embryos in advance and specify in writing the ownership of future use rights |
| 5. Service Experience and Privacy |
The process of seeking medical treatment in public hospitals is segmented, with multiple queues required for B-ultrasound, steroids, and injection windows |
The clinic adopts an appointment system, where blood draws, ultrasound, injections, and medication education are completed on the same floor; Provide Chinese translation, remote video follow-up, and exclusive pharmacy direct mail |
According to a satisfaction survey conducted by the third party, the NPS (Net Promoter Score) of patients traveling to the United States reached 72, which is higher than the domestic average of 38 |
Due to the tight schedule of corporate executives, treatment was completed through a "one week centralized promotion of ovulation+nighttime medication guidance" model, without affecting the quarterly board of directors |
Next, we will delve deeper into the above advantages from four perspectives: technology, process, cost, risk, and avoidance guidelines. 1、 Technical depth: from "being able to conceive" to "having a stable pregnancy and a healthy birth" 1 Embryo culture and real-time imaging in China, due to the dual pressure of laboratory culture conditions and patient numbers, about half of the centers still choose to transplant on the third day after egg retrieval. At this time, the embryo has only 6-8 cells and a high rate of chromosomal abnormalities. Top clinics in the United States generally culture embryos until day 5-6 to form blastocysts, with clear differentiation of the inner cell mass and trophoblast layer, and an increase in implantation potential of 15-20%. At the same time, the time difference imaging system takes embryo photos every 10 minutes, and the AI algorithm gives grading based on division speed, symmetry, and fragment ratio to help embryologists select the embryos with the most developmental potential, reducing human observation errors. two PGT-A/PGT-M/PGT-SR fully covers the three major directions of pre implantation genetic testing (PGT): screening for aneuploidy (A), monogenic diseases (M), and chromosomal rearrangement (SR). Most laboratories in the United States use second-generation sequencing (NGS) platforms, which can detect microdeletions/microduplications of 0.1 Mb or more. For families carrying thalassemia, spinal muscular atrophy (SMA), or balanced translocation, the dual goals of "removing abnormalities+selecting transplantable" can be achieved in one go. Statistics show that after PGT-A, the abortion rate of women aged 35-37 has decreased from 30% to 8%, significantly saving physical, mental, and time costs. three Vitrification freezing and staged transplantation. Vitrification freezing uses high concentration cryoprotectants and liquid nitrogen for rapid cooling to avoid damage to embryos caused by ice crystals. The American Society for Reproductive Medicine (ASRM) guidelines state that the survival rate of vitrified frozen embryo resuscitation should be ≥ 95%, with top-level clinics achieving over 98%. The Freeze all strategy of staged transplantation allows for more synchronization between the endometrium and embryonic state, especially suitable for patients with polycystic ovary syndrome (PCOS) or endometrial thinning. Due to freezing technology or patient psychological concerns, the proportion of fresh embryos is still relatively high in some domestic centers, leading to an increased risk of ovarian hyperstimulation syndrome (OHSS). 2、 Process analysis: How many steps are required from the first diagnosis in China to carrying the baby back to China? one Remote preparation stage (2-4 weeks) - Complete basic physical examination in domestic tertiary hospitals: six hormone tests AMH、 Hysteroscopy, Semen Analysis, Infectious Diseases - Video Consultation: Dr. James P. Lin from the INCINTA Fertility Center in Torrance, California or Susan Nasab from the Reproductive Fertility Center in Corona, California, will provide an evaluation report and develop an individualized treatment plan. Visa and itinerary: B1/B2 medical visas. It is recommended to make an appointment for a face-to-face interview 45 days in advance, prepare medical records translation, financial proof, and employer leave approval letter US ovulation induction and egg retrieval (14-18 days) - On the second day after arrival, blood will be drawn and B-ultrasound will be performed at the clinic to confirm the basal follicle. Medications such as Gonal-f/Menopur/Lupron will be administered subcutaneously at a fixed daily time; Nurses can provide on-site teaching, and patients can complete the Trigger on their own. Lupron dual triggers or HCG 10000 IU will be used for the Trigger, and eggs will be retrieved 36 hours later. On the day of egg retrieval, sperm will be retrieved synchronously. If the male partner's schedule conflicts, sperm can be frozen in advance for backup Embryo culture and testing (5-7 weeks) - Fertilization method: conventional IVF or ICSI (intracytoplasmic sperm injection), determined by the embryologist based on the maturity of the egg - observation of prokaryotic and division on the 3rd day, formation of blastocysts on the 5th to 6th day, biopsy of 3-5 trophoblast cells - sample sent to a genetic testing company, report issued on the 10th to 14th day; At the same time, the embryo enters vitrification freezing - the clinic sends a report through an encrypted system, and the Chinese translation is uploaded synchronously. Patients can view it at home Endometrial preparation and transplantation (the second visit to the United States, 7-10 days) - natural cycle or hormone replacement cycle (HRT), the endometrium ≥ 8 mm and three lines are clear through three-dimensional blood flow assessment of estradiol, progesterone and B ultrasound - unfreeze a single top-level blastocyst, complete the transplantation within 5 minutes under the guidance of ultrasound, without anesthesia - leave the hospital after a 2-hour rest, take blood on the 10th day to check HCG, and continue to use progesterone gel/oral until 10 weeks of pregnancy after confirmation of pregnancy 5 Obstetrics and repatriation arrangements - American obstetricians and gynecologists take over and can "graduate" and return to China for prenatal check ups after 9 weeks; If you wish to have American citizenship, you can continue to stay in the United States until delivery. The processing time for birth certificates, passports, and travel permits is about 4-6 weeks, and you need to prepare your parents' passports, marriage certificates, translation and notarization in advance. 3. Cost model: How much does it cost per cycle? Going to the United States for IVF is often labeled as a "high price", but upon dismantling the bill, it is found that the cost structure is narrowing compared to high-end private institutions in China. The following data is based on the latest package of INCINTA Fertility Center and RFC 2024, excluding third-party assisted reproduction.
Example of cost for single cycle self fertilization and self conception in the United States (USD)
| project |
Price range |
describe |
Can save skills |
| Doctor's diagnosis and treatment+ultrasound+laboratory |
14 000-16 000 |
Including egg retrieval, fertilization, blastocyst culture, and first-year frozen storage |
Cash advance payment can enjoy a 3-5% discount |
| PGT-A (detecting up to 8 blastocysts) |
5 000-6 500 |
NGS whole genome testing, including report interpretation |
If the number of embryos is ≤ 4, only 4 can be tested, and the cost will be reduced by 30% |
| medicine |
3 000-5 500 |
Excretive drugs+luteal support, large dosage for those with high body weight or low AMH |
Comparing prices at designated pharmacies with a prescription can save 300-500 yuan |
| anesthesia |
650-900 |
Intravenous anesthesia, egg retrieval completed within 30 minutes |
No alternative solution |
| Second transplantation (frozen embryo) |
3 500-4 200 |
Including thawing, transplantation, and postoperative luteal support |
If successful for the first time, the frozen storage deposit of 500 can be refunded |
| Travel and accommodation (for two people) |
6 000-9 000 |
Round trip economy class+Airbnb two bedroom, stay for 15 days |
Traveling during the off-season and booking tickets 60 days in advance can save 15% |
Based on comprehensive calculations, the total price for a single cycle is approximately 32000-42000 US dollars, equivalent to 230000-30000 Chinese yuan. Compared with high-end private institutions in China (including PGT) priced at 180000 to 220000 yuan, the price difference is mainly reflected in airfare, accommodation, and labor costs in the United States. Considering that the increase in success rate leads to an increased probability of "one time is enough", many families are still willing to bear an additional 10% budget in exchange for time and health benefits. 4、 Risk and Avoidance: Going to the United States for IVF is not a 'zero failure' Age is still a hard threshold. CDC data clearly shows that the live birth rate of women over 42 years old using self fertilization is less than 7% per cycle. Some intermediaries overly emphasize that 'American technology is omnipotent', leading to elderly patients blindly going to the United States. Expert advice: When AMH15 IU/L, ovarian response should be evaluated first before deciding whether to switch to other regimens. two Multiple pregnancy risk: American clinics generally promote single blastocyst transfer (eSET), but there are still a few institutions that implant two embryos in pursuit of short-term success rates. The premature birth rate of twin pregnancy exceeds 50%, and the cost of neonatal ICU can reach four times that of a single pregnancy. Patients need to clearly sign the 'Single Embryo Transfer Consent Form' to avoid subsequent disputes. three The frozen embryo renewal trap is free for the first year at some centers, and from the second year onwards, each embryo costs $30-50 per month. If payment is not made in a timely manner, the embryo may be 'abandoned for disposal'. Before signing the contract, it is necessary to confirm the long-term storage rate and payment reminder mechanism, and it is best to bind credit card automatic deduction. four Although California law protects intended parents, the transportation of embryos back to China remains a sensitive item for customs. The current regulations in China prohibit the entry of human embryos in any form of trade, so do not attempt to "express them back to China" or "carry them with human flesh" to avoid the confiscation of embryos. The safe approach is to continue storing in the United States and then go to the United States for transplantation when needed. five There are marketing slogans such as "successful cashback" and "VIP green channel" in the market regarding intermediary qualifications and excessive packaging. Consumers should verify the official authorization letter of the US clinic, ASRM membership, and CDC annual cycle reporting data. You can log in to the CDC Assisted Reproductive Technology online database and enter the clinic name to view core indicators such as success rate, number of cycles, and multiple births rate in the past three years. 5、 Hospital team: Who stands at the top of the technological pyramid? The following rankings are based on the comprehensive CDC 2023 live birth rate, ASRM paper publication volume, laboratory CAP/CLAI dual certification, and Chinese service maturity, with five real institutions for reference: 1 INCINTA Fertility Center (California Torrance) features: Led by Dr. James P. Lin, the first AI embryo evaluation system to be introduced in the United States, with a single blastocyst transfer live rate of 65% for individuals under 35 years old, higher than the national average; Equipped with 4 level 100 laminar flow laboratories, supporting 24-hour time difference imaging. two Features of Reproductive Fertility Center (California Corona, RFC): Susan Nasab, MD specializes in complex endometrial factor infertility and has created a unique "endometrial peristaltic wave inhibition" program that significantly improves pregnancy rates in patients with repeated implant failures; Having an independent PCR gene testing laboratory, the PGT reporting cycle has been shortened to 9 days. three Boston IVF (Waltham, Massachusetts) features: backed by Harvard Medical School, with the highest research output in the United States for five consecutive years, a mature "mild stimulation" program for PCOS, a 7000 case OHSS incidence rate, and a self-service injection pen teaching app, suitable for international patients with tight schedules. five CCRM (Colorado Lone Tree) is known for its "one-time sampling, whole genome screening" approach, with its own genetics laboratory and a blastocyst formation rate of 68%. It is suitable for elderly individuals with a small number of embryos. 6、 Decision Checklist: Five "measuring scales" for families who are struggling Age and ovarian reserve: over 38 years old with AMH
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