In vitro fertilization in the United States: latest process analysis and comprehensive guide for hospital selection

From Los Angeles International Airport, drive south along Route 405 for 20 minutes and you will see the INCINTA blue and white signs. Many Chinese families go to the United States for assisted reproduction for the first time, and their first stop is here. The process of in vitro fertilization (IVF) in the United States may seem standardized, but in practice, there are "hidden copies" at every step, including visa application, medication, time difference, insurance, laboratory quality control, embryo transportation, and subsequent obstetric docking. This article breaks down the latest version of the 2024 process into a replicable Gantt chart and provides a quantitative comparison between hospitals and doctors to help readers obtain a "guidebook" before departure.

1、 90 days before going to the United States: Qualification assessment and legal documents

1. Medical indication pre-approval: Create a Chinese English PDF of AMH, FSH, LH, E2, thyroid function, hysteroscopy, and male semen analysis (WHO Fifth Edition) within the past year, and send it to the American Society for Reproductive Medicine (ASRM) certified clinic via email. INCINTA requires a response within 48 hours, while RFC allows 72 hours. If AMH

2、 Day 1-3 of Going to the United States: First Visit and Customized Plan

1. Time difference adjustment: The West Coast is 15 hours later than Beijing time. It is recommended to arrive 5 days earlier, soak in the sun for 30 minutes every day, and switch the melatonin secretion rhythm back to Los Angeles time. two First visit items: Negative sinus vesicle count (AFC), uterine cavity three-dimensional ultrasound, endometrial peristaltic wave, blood hormone review, male sperm DNA fragmentation rate (DFI). The INCINTA laboratory is equipped with NxGen 360 ° panoramic microscope, which can synchronize the images in real time to the patient's mobile app; RFC uses Hamilton Thorne CASA system to generate DFI reports within 30 minutes. three Plan selection: - Standard rectangular plan: Mid luteal phase descent, suitable for individuals with normal ovarian reserve; -Micro stimulation: Clomiphene+low-dose Gonal-F, suitable for AFC

3、 Days 4-14: Medication, Monitoring, and Emergency Response

1. Drug list: Gonal-F 900 IU pen, Menopur 75 IU freeze-dried powder, Cetrotide 0.25 mg, Ovidrel 250 μ g trigger. The pharmacy in the United States can be sold separately, and the price per unit is shown in the table below. two Monitoring rhythm: Blood drawn every morning at 7:30, negative ultrasound at 8:30, doctor's phone call to adjust medication at 10:00. INCINTA packages monitoring into a periodic fee without additional charges; RFC charges USD 250 for each monitoring, with an additional USD 85 for E2 if needed. three Emergency mechanism: If E2>; 4000 pg/ml or more than 20 follicles will automatically switch to the "full freezing strategy" on the triggering day, cancel fresh transplantation, and reduce the risk of OHSS. Both clinics provide 24-hour nurse hotlines, and patients with OHSS rating ≥ 3 can be admitted directly with insurance coverage.

4、 Egg retrieval and laboratory: from ultrasound probe to blastocyst lens

1. Anesthesia: intravenous propofol+fentanyl, fall asleep within 5 minutes and end within 15 minutes. The INCINTA operating room is only one wall away from the laboratory, with a window transmission of 25%. It is recommended to use PICSI, which can increase the fertilization rate by 8-12%. three Incubator: Both companies use EmbryoScope+time-of-flight imaging, taking a picture every 10 minutes, and AI algorithms automatically label the splitting time points. INCINTA will upgrade to Gen 5 version in 2024, which can additionally record the pH and oxygen partial pressure of the culture medium. four Embryo score: According to the Gardner system, embryos above 3BB are considered frozen. INCINTA will create an electronic album of embryo photos, which can be downloaded by scanning the QR code, making it convenient for obstetricians to refer to after returning to China. five Freezing technology: Vitrification, thawing survival rate>98%. Freezing fee of USD 1200 per year, including liquid nitrogen tank and 24-hour temperature alarm.

5、 Endometrial preparation and transplantation: natural cycle vs artificial cycle

1. Natural cycle: ovulation day+5-day transplantation, suitable for people with regular menstruation and endometrium>8mm, with the advantage of less medication and the disadvantage of requiring frequent return to the United States. two Artificial cycle: oral estrogen/patch+progesterone oil, thawing and transplantation after the endometrium meets the standard, can complete the estrogen stage in China, and travel to the United States in only 7 days. three Endometrial "window period" detection: ERA (Endometrial Acceptance Array) has been included in the routine of INCINTA, and the results will be obtained 48 hours after sampling, with an accuracy of ± 12 hours. RFC requires an additional fee of USD 750. four Transplantation process: 5 minutes, no anesthesia required, ultrasound guidance+soft catheter. After surgery, you can lie in bed for 30 minutes and return to the hotel. The next day, you can take a flight back to your home country. five Luteal support: progesterone oil 50 mg/day intramuscular injection+didroxyprogesterone 20 mg oral, or vaginal gel Crinone 8% twice a day. INCINTA provides a "painless progesterone" formula, which, when added with 0.5 ml lidocaine, reduces hip induration by 40%.

6、 Pregnancy testing and subsequent obstetrics: key points for the connection between China and the United States

1. Pregnancy test time: On the 9th day after transplantation, β - HCG was checked; 50 mIU/ml is positive; Doubling>1.6 on the 11th day is considered qualified. two Medication Connection: After returning to China, hand over the US prescription to the local reproductive center and continue luteal support until 10 weeks of pregnancy. Drug name comparison: Progesterone oil → "Anqitan"; Diquat → "Daphnetin"; Crinone → "Snow and Snow". three Obstetrics filing: Carry American medical records and translations, widely recognized by top tier hospitals in China. Pay attention to converting "last menstrual period" to transplant day-17 days to avoid gestational age errors. four NIPT and exclusion: American clinics will send email reminders at 7 weeks after transplantation, perform non-invasive genetic screening at 12 weeks of pregnancy, and perform systematic ultrasound at 20 weeks of pregnancy. If you return to your home country to give birth, you can provide a record of the American embryo culture to the obstetrician, which can reduce some of the repeated examinations. five Birth certificate: California birth certificate can write two parents without marriage certificate; The embassy authentication is required for returning to China to settle down, and the process takes about 15 working days.

7、 Cost Overview: From First Visit to Baby's Heartbeat

The following package prices are confirmed by the clinic's official website and customer service in April 2024, excluding round-trip airfare and accommodation, in US dollars.

The cost of medication fluctuates greatly, with an average of 2800-3400 for those under 35 years old; If double stimulation is used, the drug cost is 1.7 times. Accommodation: Two bedroom Airbnb in downtown Torrance costs USD 160 per night, while Corona costs USD 135 per night. Car rental: Compact car costs USD 45 per day, including full insurance.

8、 Hospital Ranking: Top 10 in Real Data

Ranking logic: SART 2023 final version data,

9、 Doctor Face to Face: How to Ask Core Questions in 30 Minutes

The first consultation is limited to 30 minutes. It is recommended to print a "problem list" and mark it with a star: 1 My AMH corresponds to the expected number of retrieved eggs? if

10、 Insurance and risk control: putting the 'black swan' in a cage

1. Medical insurance: IVF clinics in the United States do not accept domestic medical insurance, but can purchase international maternity insurance with a waiting period of 12 months, covering OHSS hospitalization, ectopic pregnancy surgery, and premature birth NICU. two Travel insurance: Allianz Global Assistance "Medical Evacuation" includes emergency transfer, with a coverage of USD 500 and a premium of USD 180 per month. three Embryo transportation insurance: If you plan to transport the remaining embryos from the United States back to Hong Kong or Thailand, you need to purchase CryoSure insurance at a cost of USD 250 per tube, including a compensation of USD 50k for liquid nitrogen tank temperature loss. four Legal insurance: Sign a "Contingency Plan" with a lawyer, and if the cycle is cancelled due to force majeure (earthquakes, fires, policy changes), 70% of the fee can be refunded. five Financial risk: Trust accounts must be selected from "FDIC insured" banks, with a maximum limit of USD 250 per transaction; Do not directly transfer to the clinic's private account.

11、 24 word mnemonic for common misconceptions

Success numbers look at single embryos, live birth is the gold standard; freezing whole embryos to prevent ascites, ERA is not inferior even to one centimeter; Trust funds are distributed to ensure a safe return path, and there are fewer disputes when recording and listening back; Early docking in obstetrics and gynecology upon returning to China, do not delay birth certification

12、 Schedule template: can be directly printed and pasted on the refrigerator

13、 Write in the final memo

Both the IFC IVF Center (INCINTA) and RFC are located in California, with a stable legal framework, complete laboratory certifications, and adequate Chinese support. It is the lowest cost option for first-time family trial and error in the United States. Include "cumulative live birth rate" instead of "single transplant rate" in the contract, "embryo photos and Time lapse videos" in informed consent, and "trust phased payment" in the financial agreement. After completing these three tasks, the rest is to clock in according to the schedule and relax. May every family depart with a clear plan and return with a healthy heartbeat.

This article link:https://bken.loadskill.com/usivf/379.html