Guide to IVF in the United States: Detailed explanation of process, cost, and hospital selection

Going from China to the United States for IVF is not only a medical journey, but also a cross-border life management. Breaking down the process into a "timeline+task list", breaking down expenses into "hospital bills+living bills", and then breaking down hospitals into "hard indicators+soft experiences" can make this journey calculable, predictable, and achievable. The following text is presented in a dual track format of "table+text" for easy printing and direct use as a guide.

1、 Full process timeline (taking single cycle fresh embryo transfer as an example)

Stay in the United States for approximately 28-35 days throughout the entire process; If the current month is not suitable for fresh embryos, the eggs will be retrieved and returned to China, and the freezing cycle will be changed. The second trip to the United States only takes 7-10 days.

2、 Cost Overview: Hospital Bill vs. Life Bill

Single cycle total: approximately $15000-22000 for the hospital portion; The living expenses are about 6000-8000 US dollars. If double cycles are required, the hospital portion will be 1.7 times (saving medication costs and full surgical fees), and the living portion will be 1.3 times.

3、 How to choose a hospital: 7 hard indicators+3 soft experiences

Hard indicators: ① Laboratory certification (CAP/CLAI dual certification); ② Average length of service for embryologists; ③ PGT-A sampling success rate; ④ Live birth rate (available on the CDC website for age groups under 35 and 38-40); ⑤ Is the Chinese coordinator full-time; ⑥ Periodic quantity (experience curve is more stable for cases>500 per year); ⑦ Do you accept full payment by international credit card.

Soft experience: ① Apartment walking distance ≤ 10 minutes; ② Do Chinese nurses work in shifts; ③ Is there a dedicated WeChat group for real-time Q&A.

4、 2024 Los Angeles/New York Mainstream Reproductive Center Ranking (based on CDC 2022 live birth rate+comprehensive score of Chinese services)

Note: The live birth rate data are all from the 2022 edition of the Assisted Reproduction Technology Report by the CDC in the United States, which is a single cycle statistical analysis of autologous fresh embryos under the age of 35; The Chinese service was obtained from the 2024 Q1 questionnaire of Third Party research institution, with a sample size of n=312.

5、 Visa and Entry: B2 is the Most Stable, Don't Forget EVUS

1. Visa type: B2 tourist medical visa. It is normal to truthfully answer "going to the United States for assisted reproduction" on site, so there is no need to conceal it. 2. Material list: appointment form, doctor invitation letter, asset proof (balance ≥ 300000 yuan), English itinerary, return flight ticket. 3. EVUS: Passport Validity Period

6、 Medication Differences: Chinese American Dose Comparison and Cost saving Techniques

American doctors tend to adopt a "low-dose multiple follow-up" regimen, with common antagonist regimens starting at Gonal-F 225 IU and adjusted every 2 days; Many domestic centers start with 300 IU directly. Money saving tips: ① 3-4 days before ordering in China, the drug price is only 60% of that in the United States; ② Replacing Si Zekai with Fyremadel antagonist is about $20 cheaper per unit; ③ Combined with GoodRx coupons, chain pharmacies offer an additional discount of 8-15%.

7、 Laboratory techniques: Time Lapse, AI Embryo Scoring, Microstimulation

1. Time Lapse: Take photos every 10 minutes to avoid repeated unboxing, embryo damage ↓ 10%, and implantation rate ↑ 5-7%. 2. AI scoring: Using the KIDScore D5 algorithm to grade embryos from 1 to 10, selecting embryos with a score of ≥ 7 can reduce the miscarriage rate to 8%. 3. Microstimulation: Suitable for AMH

8、 Anesthesia and Egg Retrieval: American "30 Minute Sleep" Process

99% of centers in the United States use intravenous propofol anesthesia, fasting for 8 hours before surgery, waking up for 30 minutes after surgery, and being able to go home within 2 hours. On that day, one adult must accompany and Uber/Lyft is not allowed. After surgery, ibuprofen and acetaminophen dual channel analgesia were administered, and 90% of patients had pain scores within 24 hours

9、 PGT-A Sampling: When to Do, How to Do, Risk Points

Sampling timing: Day 5/6 blastocyst stage, take 4-8 trophoblast cells without affecting the inner cell mass. Transportation: The samples need to arrive at the genetic testing laboratory within 72 hours, with mainstream partner institutions including Natera and CooperGenomics. Report cycle: The results will be available 7-10 days after biopsy, and the freezing cycle can wait for the report before transplantation to avoid ineffective transplantation. Risk: The survival rate of embryos after biopsy is 99.2%, and the misdiagnosis rate (false positive/false negative) is about 2%. It is recommended that couples undergo SNP array validation.

10、 Endometrial preparation: natural cycle vs artificial cycle

The American center advocates for artificial cycles, which are controllable in time and do not require long-term stays for international patients.

11、 Luteal support: PIO oil, vaginal gel, oral compound

Traditional progesterone oil 50 mg/day intramuscular injection, priced at $2/tube, disadvantage: local hardening. Alternative: Crinone 8% vaginal gel, once a day, no pain, the price is $6/piece. The latest composite scheme: oral administration of Utrogestan 200 mg bid+vaginal gel qod, stable blood concentration, patient satisfaction ↑ 18%.

12、 Pregnancy Testing and Early Pregnancy Management: When to Return to China and How to Transfer Files

Blood β - hCG ≥ 50 IU/L is considered positive, and doubling by>1.6 times every other day is sufficient. On the 28th day after transplantation, the gestational sac was detected by ultrasound, and on the 42nd day, the fetal heart rate was observed, indicating graduation. Before returning to China, ask American doctors to provide a "pregnancy confirmation letter" and an English medical record, and the obstetrics department in China can directly establish a medical card without the need for repeated examinations. Flight selection: It is safe to fly before 12 weeks of pregnancy. It is recommended to choose a direct flight with cabin pressure equivalent to an altitude of 1800 meters, which has no impact on the fetus.

13、 Insurance and Accidents: International Medical Insurance, Complications Insurance, Refund Plan

1. International medical insurance: covers acute ovarian hyperstimulation syndrome (OHSS) and ectopic pregnancy rupture, with a coverage of ≥ 1 million US dollars and a premium of 300-600 US dollars. 2. Complications insurance: If hospitalization for moderate to severe OHSS occurs, a daily subsidy of $500 will be provided for a maximum of 7 days. 3. Refund Plan: Some centers offer "multi cycle packages", with a 50% refund for 3 cycles without clinical pregnancy, suitable for those over 38 years old or AMH

14、 Living facilities: apartments, supermarkets, traditional Chinese medicine rooms

Torrance District, Los Angeles: A 5-minute walk to Dahua Supermarket, where you can buy local chicken, astragalus, and red dates; Recommended apartment is "Marbella Village", with a two bedroom monthly rent of $3800, including parking and washing machine. Corona District: Across from RFC Clinic is 99 Ranch Supermarket, apartment "Alta Vista" with a monthly rent of $3200 and breakfast included. Manhattan, New York: Recommended "West 57th Street" serviced apartments near New Hope, with a monthly rent of $5200, expensive but cost-effective for commuting.

15、 Laws and documents: birth certificate, passport, travel document

The child will receive a US birth certificate upon birth, and both parents' passports, marriage certificate, and translated documents can be processed. Birth certificates can be obtained within 5 working days after birth, US passports within 2 weeks, and Chinese travel permits within 4 weeks. The total cost is about 600 US dollars. Reminder: The birth certificate must be expedited, otherwise it will affect the return flight ticket.

16、 List of common pit locations

① The 'low-priced package' does not include medication costs, with an additional $4000 at checkout; ② The temporary thawing fee for frozen sperm is $500 per time; ③ If the PGT-A report is overdue, the laboratory will charge an additional late fee of $200 per day; ④ The apartment is booked in Santa Monica, and it takes 1 hour to drive to Torrance during the morning rush hour, which delays morning blood; ⑤ Domestic insurance does not cover overseas test tubes, so the invoice brought back cannot be Reimburse.

17、 Time cost optimization model (30 years old, AMH 3.5 ng/mL)

Goal: One egg retrieval, one transplantation, to achieve a healthy singleton pregnancy. The optimal path: 4-day domestic promotion of ovulation → 10 day trip to the United States → fresh embryo transfer → pregnancy test on the 28th day → graduation on the 42nd day. Hospital bill: $17200; Living expenses: $6500; Airline ticket: $1600; Insurance: $400; The total amount is 25700 US dollars. If successful once, the cost will be capped; If not pregnant, the freezing cycle costs an additional $4200, which is still lower than the national average.

18、 Psychology and Relationships: Partner Communication under Cross Border Pressure

Suggest setting a fixed "15 minute round table" every day, not talking about medical care, only about feelings; Use the app "Headspace" for meditation to lower cortisol levels; On the day of egg retrieval by the female partner, the male partner sending a bouquet of flowers can significantly improve relationship satisfaction (UCLA 2023 study).

19、 Nutrition and Exercise: Mediterranean Diet+Walking as the Main Approach

Promotion period: 1.5 g/kg body weight of protein per day, salmon, avocado, walnut; Avoid high sugar beverages, OHSS risk ↓ 30%. After transplantation: Walk 6000-8000 steps daily, avoid prolonged lying down, pelvic blood flow increases by 18%, and implantation rate increases.

20、 Next stop: Second child interval and embryo survival

Suggested interval for vaginal delivery is 18 months; Cesarean section at 24 months. The storage fee for frozen embryos starts at approximately $600 per year from the second year, with a 10% discount for early renewal. When planning to have a second child, contact the US center three months in advance and prepare manually. The trip to the US can be completed in just seven days.

Print the above 20 modules into a pocket book and follow the "tick cross" rhythm. The road to IVF in the United States will change from "unknown" to a "visualization project". Wishing you a speedy recovery from fetal heart disease and a smooth graduation.

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