Detailed explanation of the entire process of in vitro fertilization in the United States: time, cost, and precautions

Completing an in vitro fertilization (IVF) cycle in the United States takes an average of 60-90 days, with a total budget of $32000-48000, of which over 60% occurs in the embryonic laboratory and clinical operations. Understanding the timeline, cost composition, and risk nodes is the first step for families to make cross-border decisions. The following text takes the "cycle calendar" as the main line, breaks down the medical goals, required days, key examinations, common additional items, and corresponding price ranges for each step, and provides a practical checklist for remote preparation between China and the United States, making it easy for readers to implement 80% of the preparation work before going to the United States.

1、 Overview of Cycle Calendar

2、 Timeline disassembly

1. First domestic consultation (2-5 days of menstruation)
It is recommended to choose a reproductive specialist tertiary hospital and complete the six hormone tests (FSH, LH, E2, PRL, T, P), AMH, and antral follicle count (AFC). If there is a history of uterine cavity operation, hysteroscopy should be performed to exclude adhesions; If the male's semen routine indicates a concentration<10 × 10 ⁶/ml or vitality<20%, the sperm DNA fragmentation rate (DFI) will be simultaneously completed. All reports can be issued within 3 days, scanned and uploaded to the encrypted system of the US clinic. The doctor will provide a preliminary medication plan within 48 hours.

2. Remote video consultation (7 days after the first consultation)
Taking the IFC IVF Center (INCINTA) in the United States as an example, Dr. James P. Lin will classify patients into three categories based on AMH and AFC: high response, normal response, and low response, and determine the type and dosage of ovulation inducing drugs: high response patients are more likely to use GnRH antagonist regimen, while low response patients may be given Growth hormone or DuoStim. At the end of the video, an electronic prescription will be generated, and patients can place orders on the designated platform. The medication will be shipped directly from the US pharmacy to Hong Kong, and it will take 3-5 days to arrive. Patients can pick it up with a doctor's certificate.

3. Promoting ovulation stage (menstrual period D2-D12)
The medication includes gonadotropins (Gonal-F, Menopur), antagonists (Cetrotide), and trigger needles (Lupron or hCG). Subcutaneous injection at 9pm daily, with dosage recorded on the mobile app. Starting from the 6th day, E2 and LH will be rechecked at domestic institutions, and the results will be returned to the United States for doctors to adjust the dosage. When the two dominant follicles are ≥ 18 mm and the E2 level reaches 250-300 pg/ml/follicle, stop promoting ovulation, administer trigger injections, and travel to the United States 36 hours later.

4. Going to the United States for monitoring (menstrual cycle D10-D14)
After entering Los Angeles International Airport, proceed directly to INCINTA's Pavilion B campus in Torrance and complete blood draw and negative ultrasound within 30 minutes. If the number of follicles is greater than 20, the doctor will recommend general anesthesia for egg retrieval; If there are less than 5 eggs, it is possible to switch to a natural cycle for egg retrieval to save on medication costs. During the monitoring period, you can stay in the hospital agreement apartment, with a daily rent of $120, including kitchen and laundry, convenient for food and salt control.

5. Egg retrieval surgery (menstrual period D13-15)
On the day of surgery, fast for 8 hours and administer Propofol intravenously for a total of 15 minutes. After 1 hour of postoperative B-ultrasound confirmation of no pelvic fluid accumulation, the patient can be discharged from the hospital. The laboratory uses ICSI insemination, and the prokaryotic cells are observed 24 hours later, followed by division at 48 hours. The blastocyst formation rate is observed on days 5-7. If PGT is chosen, an additional 5-7 working days will be required for the report to be sent via encrypted email.

6. Embryo freezing and storage
Cryotec method was used for vitrification freezing, with a survival rate of 98%. The first year storage fee is $600-800, and the following year it is $600. It is recommended to freeze 2-4 blastocysts at once and avoid thawing them multiple times. The frozen label uses a dual signature system to ensure unique identity.

7. Preparation and thawing of endometrium for transplantation
Starting from the first day of the second menstrual period after egg retrieval, oral Estrace 2 mg is administered three times a day. On the 14th day, when the endometrial thickness is ≥ 8 mm and the third line sign is clear, progesterone oil 50 mg is added by intramuscular injection daily. On the day of transplantation, arrive at the hospital 2 hours in advance. The bladder is semi filled, and the embryo is guided by B-ultrasound to be sent to the upper and middle parts of the uterine cavity. After surgery, lie flat for 30 minutes before leaving. Continue luteal support for 10 weeks from the date of transplantation.

3、 Expense Detail Table (Single Cycle)

4、 Flight and accommodation budget
Round trip economy class to Los Angeles costs $800-1200, with a 30% increase during peak season. Apartments around the hospital cost $100-150 per night, and two trips to the United States for egg retrieval and transplantation, totaling 20 nights, cost approximately $2000-3000. Rent a car for $30 per day, including insurance. The overall transportation and accommodation costs range from $3500 to $4500.

5、 Insurance and Refund Plan
IVF in the United States is not included in commercial insurance, but some clinics offer a "three-stage refund plan": if three transplants do not result in clinical pregnancy, 30-50% of the cost will be refunded. Admission criteria: Female ≤ 38 years old AMH≥1.2 ng/ml、 The uterine cavity is normal. Psychological assessment and FDA infectious disease screening are required before signing the contract.

6、 Common Additional Projects
1. Intrauterine infusion PRP: increases endometrial blood flow, $500/time, performed 3 days before transplantation.
2. EmbryoGlue: Increases implantation rate, $250 per session.
3. Laser assisted incubation: suitable for ages ≥ 38, $350 per session.
4. Sperm electron microscopy morphology: IMSI, $400/time.
5. Embryo time-lapse photography: EmbryoScope, $800 per session.

7、 Differences in laboratory technology
INCINTA adopts a closed negative pressure embryo chamber, 24-hour online particle monitoring, oxygen concentration controlled at 5%, and temperature fluctuation ± 0.2 ℃. RFC uses modular incubators with independent chambers for each patient to avoid cross opening and closing. Both institutions have a blastocyst formation rate of 60-65%, but INCINTA has a 3-4 percentage point higher diploid detection rate, which is more advantageous for elderly patients.

8、 Medication safety and side effects
Abdominal distension and nausea are common during the ovulation induction stage, with an incidence rate of 20-30%. If there are signs of OHSS (weight gain>2 kg, abdominal circumference>5 cm), doctors will switch to Lupron triggering and whole embryo freezing. The risk of blood clots is extremely low. It is recommended to wear elastic socks during the flight and get up and move around every 2 hours.

9、 Legal and identity documents
On the day of egg retrieval, it is necessary to sign the FDA 21 CFR 1271 Human Cell Tissue Regulations Notification Letter and confirm that there is no travel history of infectious diseases. The ownership of embryos is stated as "jointly owned by biological parents", and if divorced, it shall be handled in accordance with California Family Law Section 7613. Frozen embryos can be stored for up to 10 years, and renewal accounts can be charged remotely to credit cards.

10、 Visa and Entry to the United States
Recommend B1/B2 ten-year visa, bring a doctor's appointment letter, cost estimate, property ownership certificate, and bank statements during the interview to prove the ability to self fund medical treatment. When entering Los Angeles, customs often ask for "purpose of stay", answer "medical treatment for fitness" and present an appointment letter, usually giving a stay of 6 months. The original prescription and English translation are required for carrying drugs with you, and the insulated box and ice cream are used for refrigerated injections. After declaration, they will be released.

11、 Hospital Ranking and Characteristics (2024 CDC Report Data)

12、 Payment terms and exchange rates
Most clinics accept Visa/Master credit cards with a maximum limit of $50000 per transaction. If purchasing foreign exchange from China, it is recommended to make an appointment through mobile banking 3 working days in advance. When remitting, please note "medical fee" and keep the SWIFT receipt. After returning to China, you can use the hospital invoice to make a special additional deduction for personal income tax at the tax bureau (which needs to be translated and notarized).

13、 Frequently Asked Questions and Answers
How many days is the minimum stay for a trip to the United States?
Answer: The egg retrieval process takes 12 days, the transplantation process takes 7 days, and if remote medication is chosen, it can be combined into one 18 day session.
Does the man have to be present?
Answer: Semen needs to be collected on the day of egg retrieval. If the male partner is unable to travel to the United States, a sample can be collected at the local HRC satellite laboratory one month in advance and air freighted to INCINTA, with a shipping fee of $300.
Can embryos be transported?
Answer: Yes, you need to fill out the FDA 2800 form and use dry ice cans for transportation, with a cost of $1200. The destination must have a laboratory with the corresponding qualifications to receive it.
If the first transplant fails, how much does it cost for the second one?
Answer: Thawing+transplantation costs $3500, medication costs $300, and there is no need for repeated ovulation induction.

14、 Obstetrics connection after returning to China
After a successful pregnancy test, it is recommended to continue monitoring in the United States until 9 weeks of pregnancy and obtain a fetal heart rate report and medication list. After returning to China, bring English medical records, ultrasound images, and medication dosage tables to the obstetrics department of a local tertiary hospital to establish a medical card. Doctors will continue to prescribe progesterone at the same dose. NT at 12 weeks of pregnancy and non-invasive DNA at 16 weeks of pregnancy can be completed domestically. American hospitals can provide remote consultations, and if threatened miscarriage occurs, medication can be adjusted by email within 24 hours.

15、 Psychological and time costs
In addition to economic expenses, the biggest hidden cost of cross-border IVF is emotions. It is recommended that couples undergo a joint psychological counseling before starting, setting "two egg retrieval and three transplantation" as the psychological stop loss point. Join the hospital's online patient group to share medication reminders in real-time and reduce anxiety. The female partner continues to work remotely during the ovulation promotion stage, avoiding night shifts and high-altitude flights, while the male partner's full companionship can significantly improve satisfaction.

16、 Summary
IVF in the United States attracts patients worldwide with transparent procedures, standardized laboratories, and a comprehensive legal framework. A single cycle of 30000 to 40000 US dollars, a 60-90 day timeline, and a detachable two-stage trip to the United States, allowing domestic families to complete the core process with only 20 days of leave. Choosing Chinese friendly clinics such as INCINTA or RFC can minimize language and cultural friction to the greatest extent possible. By completing inspections, remote planning, medication mailing, and visa material preparation domestically in advance, the on-site time can be compressed to the shortest possible time, and the success rate and comfort can be simultaneously pulled to the optimal range.

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