2024 Analysis of the Whole Process of IVF in the United States: Costs, Processes, and Precautions

In 2024, more and more Chinese families are turning their attention to assisted reproductive institutions on the West Coast of the United States, hoping to use mature technology and relatively relaxed regulations to fulfill their wish of being able to conceive and give birth. The United States is not a paradise for those who want to be born, but it does have global leading advantages in laboratory standards, medication regimens, embryo culture systems, and obstetric connections. This article uses a "timeline+cost table+avoidance checklist" approach to break down a complete path from domestic launch to returning home with a child, making it easier for readers to make quantifiable decisions before departure.

1、 First, calculate the economic account: 2024 average bill for IVF in the United States

The CDC in the United States releases the national average cycle cost once a year. The 2023 annual report shows that a single cycle of "self fertilization" costs about $43000. However, the data also includes a large number of cycles that only promote ovulation without transplantation, which has limited reference value for Chinese families. Based on the latest price list of mainstream clinics on the West Coast such as INCINTA and RFC in February 2024, as well as the real payment records of our accompanying families in the past three years, the following "itemized price list" can be disassembled.

The above figures do not include living costs such as airfare, accommodation, meals, car rental, insurance, etc. Taking Los Angeles as an example, the regular living expenses for a couple staying for 30 days (15 days for ovulation induction and 15 days for transplantation) are approximately $6000-8000. If the gentleman is unable to accompany the entire journey and requires two round trips, an additional $2000-2500 airfare will be charged. Overall, the budget range for a "one-time" self fertilization journey is between 48000-55000 US dollars, equivalent to 340000 to 400000 Chinese yuan (estimated at an exchange rate of 7.2).

2、 Timeline: From the first day of menstruation to holding the baby and being discharged from the hospital

Clinics in the United States generally adopt a "phased itinerary" to reduce the number of days off. We have divided the process into five sections, each providing the earliest possible departure time for everyone to request leave from the company.

3、 How to choose a hospital: CDC ranking+Chinese family experience

The "Success Rate Ranking" by the CDC in the United States only focuses on fresh self egg transplantation under the age of 35, with limited reference for Chinese families; We use "self fertilization for individuals over 38 years old, single embryo transfer, and live birth rate" for internal ranking, and combine four indicators of Chinese language services, accommodation radius, billing transparency, and obstetric facilities to come up with the 2024 version of the "China Family Friendly List".

4、 Visa and Entry: Honest Visa vs. Tourist Visa, How to Answer Customs in 2024

1. Visa type: B1/B2 is sufficient, no medical visa is required. 2. Focus of the interview: VO is most concerned about "who will bear the expenses and whether there is a tendency to immigrate". It is recommended to bring 1) a doctor appointment letter, 2) a deposit certificate of at least 500000 yuan, 3) a company leave approval letter, and 4) a itinerary. 3. When entering Los Angeles LAX: CBP officials often ask three questions: "Purpose of coming to the United States, duration of stay, and who will pay. Answer template: We are here for medical treatment at INCINTA Fertility Center, staying 30 days, all expenses paid by our savings. Do not mention sensitive words such as baby and birth. 4. Entry documents: passport EVUS、 Round trip airfare, doctor's appointment letter, insurance policy, cash

5、 Medication plan: Differences between the American version of "Big Promotion" and China

American clinics commonly use the "long-acting GnRH antagonist" regimen, which has a short cycle and mild stimulation. The following is the 2024 standard prescription for women under the age of 38 at the IFC IVF Center in the United States, AMH 2.5 ng/ml，FSH 7.2 mIU/ml， Weight 58 kg:

Compared to similar domestic plans, the unit price of medication in the United States is 30% higher, but the dosage is generally 20% lower, and the overall cost is the same. The key difference lies in the "triggering" stage: 60% of the cycles in the United States use "dual triggering" (Lupron+HCG), which can reduce the risk of ovarian hyperstimulation (OHSS) and increase the rate of mature eggs. On the day of egg retrieval, intravenous anesthesia is fully monitored by an anesthesiologist, with the same level of supervision as the operating room, and the pain sensation is lower than that of domestic outpatient clinics.

6、 Laboratory Black Technology: Is Time lapse+AI Score Worth It or Not

In 2024, the West Coast Head Clinic has made time-lapse+AI embryo scoring a routine procedure and will no longer charge additional fees. The system takes a photo every 10 minutes, and the AI algorithm (KIDScoreD5) gives a score of 1-10. The live birth rate of blastocyst single embryo transfer with a score of ≥ 8 can reach 65%. However, the improvement of AI scores for women over 38 years old is limited, and chromosome screening (PGT-A) is still the top priority for this age group. INCINTA's 2024 data shows that in the 38-40 age group, performing PGT-A first and then selecting embryos with AI scores ≥ 7 resulted in a significant increase in single embryo live birth rate from 42.7% to 49.3%. Therefore, if the number of embryos is ≥ 5, it is recommended to do both; If there are ≤ 3 pieces, PGT-A will be given priority.

7、 Transplantation stage: Inner membrane transformation "trio"

The triple transformation of "estrogen+progesterone+estrogen" is commonly used in American clinics. The specific rhythm is: oral estradiol is taken on the second day of menstruation, endometrial examination is ≥ 8 mm on the 12th day, blood E2 is ≥ 200 pg/ml, vaginal progesterone gel is started, and transplantation is carried out on the 17th day. Unlike in China, the United States uses "natural cycle frozen embryo transfer" for 60% of its cycles, which does not require downregulation and relies on the corpus luteum function after ovulation, resulting in better synchronization of the endometrium and saving $1200 in medication costs. Applicable conditions: Menstrual regularity, normal ovulation, endometrium ≥ 8 mm. If there are polycystic or thin endometrium, artificial cycles should still be used.

8、 Obstetrics Connection: How to Package IVF Costs with Obstetrics Costs

In 2024, California will introduce a "IVF+Obstetrics" package, negotiated between clinics and hospital groups, which will save 8-12% compared to paying separately. Taking the cooperation between INCINTA and Torrance Memorial Medical Center as an example: the original price of the vaginal delivery package is $11000, and the combined price is $9500, including 12 prenatal check ups, 2 nights of hospitalization, and newborn physical examination. If upgraded to "family delivery room+painless delivery", an additional $1200 will be charged. Key terms: Payment must be made in full before transplantation to lock in the price; If pregnancy complications require early hospitalization, the cost will be charged separately. Before making a purchase, it is essential to obtain a Good Faith Estimate from the hospital, specifying the maximum amount of exemption.

9、 Baby ID: Birth certificate → Passport → Travel document → Level 3 authentication, completed in 21 days

1. Birth certificate: To be submitted within 48 hours after birth in the hospital, urgent 24-hour pickup is available, with a cost of $28 per copy. It is recommended to handle 4 copies at once. 2. Social Security Number SSN: Automatic mailing, 6-8 weeks to receive, urgent need to go to the Social Security Office, print the letter on site, can be used to buy plane tickets before returning to China. 3. US passport: make an appointment at the federal building, both parents present, bring the original birth certificate and 2 photos, expedited fee of $60, and collect within 3 days. 4. Chinese Travel Permit: To arrive at the Chinese Consulate in Los Angeles, the original passport, birth certificate, parents' passport, and marriage certificate are required. It takes 4 working days and costs $25. 5. Level 3 certification: County Secretary+Secretary of State+Consulate, totaling $150, for domestic household registration, insurance, and enrollment. The entire process, if you hire a Chinese agent, costs $1200-1500, and you can save about $400 by running it yourself.

10、 Returning to China for household registration: three major card points for household registration, medical insurance, and vaccines

1. Registration: With the Chinese translation of the birth certificate, Level 3 authentication, parents' household registration book, marriage certificate, and ID card, go to the local police station where the mother's household registration is located and apply on the spot without charge. 2. Medical insurance: After settling in, you can purchase urban and rural resident medical insurance, but for babies born in the United States, you need to pay the full premium for the current year, which is about 300-600 yuan, depending on the city. 3. Vaccine: The delivery room in the United States has received the first dose of hepatitis B+BCG vaccine. After returning home, you should bring a translation of "yellow card" to the community hospital to enter the system before continuing the follow-up vaccination. Attention: BCG vaccine is not routinely administered in the United States. If it is found that the vaccine has not been administered upon returning to China, it is necessary to receive a booster shot. Only after a negative PPD test can it be administered.

11、 Hidden costs and pit avoidance checklist

1. Additional dosage: If more than 20 eggs are retrieved and abdominal distension occurs, the doctor will prescribe albumin or diuretics, which cost $400-600 and are not covered by medical insurance. 2. Anesthesia level: Intravenous anesthesia is default for egg retrieval. If "deep sedation+intubation" is required, an additional $800 is unnecessary. 3. Embryo freezing: Starting from the second year, each clinic will charge $500-700 per year. Remember to set up automatic credit card deduction. If the payment is overdue for 30 days, the clinic has the right to dispose of it. 4. Obstetric anesthesia: The anesthesiologist's bill for painless delivery is independent of the hospital, about $1400. Confirm in advance whether it is in network, otherwise the full amount will be paid by oneself. 5. NICU: If the baby is born prematurely, the NICU costs $4000-6000 per day and can cost over 100000 in 30 days; Be sure to purchase maternity insurance that includes NICU and has a 10 month waiting period. 6. Exchange rate fluctuations: In 2024, there will be significant fluctuations in the exchange rate between the Chinese yuan and the US dollar. It is recommended to lock in the exchange rate in advance or use multi currency credit cards to reduce exchange losses by 2-3%.

12、 How to buy insurance: maternity insurance, travel insurance, and newborn insurance three piece set

1. Maternity insurance: We recommend "IMG Platinum" or "Allianz Care", with a coverage of $5 million, a waiting period of 10 months for pregnancy and childbirth complications, a premium of $2100-2400, and must be purchased before transplantation. 2. Travel insurance: Covering flight delays, lost luggage, and acute illnesses, choose "Allianz Global Travel", with a 30 day premium of 260 yuan. 3. Newborn insurance: Within 30 days after the birth of the baby, the parent policy can be added with a premium of $380-450 per month, covering routine medical examinations, vaccines, and emergency situations. Do not terminate the insurance before returning to China, otherwise re underwriting will be required for domestic purchases.

13、 Psychological construction: Success rate is not a probability game, but a "number of embryos multiplied by number of transplants"

CDC data: For a 38 year old female, the live birth rate of each chromosome normal embryo is about 55%, which means it takes an average of 2 embryos to retrieve a baby. If AMH is 1.0 ng/ml, about 3-4 blastocysts can be obtained in one round of stimulation, and about 1-2 are normal after PGT-A. It is highly likely that a second transplant will be required. Therefore, before departure, set up a "psychological account": prepare the money and time for two transplants, treat the first one as an "investment" rather than a "destination", so that emotions will not collapse.

14、 2024 New Policies Quick Look

1. The FDA has issued a new batch certification for embryo room culture oil. Starting from March 2024, all clinics must upload batch numbers, otherwise they will not be able to open cycles, indirectly resulting in a $120 increase in culture costs per cycle. 2. The California birth certificate has added a clause stating that either parent can receive it separately, eliminating the need for both parties to be present at the same time and saving one round-trip airfare. 3. The US Consulate has changed the background color of the travel document photo from white to light blue, which is not acceptable for selfies. It is recommended to go to CVS snapshot and indicate "China travel document", 4 photos for $10. 4. In many domestic areas, household registration has been tightened, and some police stations require that "one parent must be present" and cannot be entrusted, requiring prior confirmation.

15、 Understanding the entire process with a single image (text version)

Day 1 of menstruation → 14 days of domestic descent → 14 days of ovulation promotion in the United States → egg retrieval → 5 days to determine blastocyst count → 2 weeks of PGT-A → 18 days of menstruation for transplantation → 12 days of blood test → pregnancy → 12 weeks of graduation → 30 weeks of waiting for delivery in the United States → 39 weeks of delivery → 21 days of documentation → return to China for household registration. The total duration is about 11 months, with a cumulative stay of 90-100 days in the United States and a budget of 480000-550000 RMB.

16、 Conclusion

There is no magic of success in IVF in the United States, only by making each step a quantifiable KPI: number of retrieved eggs, number of normal embryos, endometrial thickness, and live birth rate. Only by budgeting thoroughly for expenses, time, and mental health in advance, and then setting off, can we turn the slogan of "going to the United States to have a healthy baby" into a to-do list on our schedule. Wishing every family the ability to turn 'wanting' into 'holding'.

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