Guidelines for IVF Application in the United States: Process, Time, and Preparation Points

The complete journey of in vitro fertilization in the United States, from visa appointment to embryo transfer, usually takes 90-180 days. If combined with hysteroscopy, immune regulation, or genetic testing, the cycle may be extended to 8-10 months. Breaking down the timeline into five major segments: "domestic preparation - initiation of travel to the United States - clinical operations - pregnancy confirmation - follow-up prenatal check ups" can simultaneously advance on the three lines of scheduling, funding, and physical health, minimizing the number of round trips and waiting gaps. The following text presents a printable "Gantt chart" in table form, and then breaks down key nodes one by one, making it convenient for families to directly compare and execute.

1、 Visa and Entry: Making 'Medical Purpose' Simple and Trustworthy

During the B1/B2 visa interview, what the visa officer most wants to hear is "money, job, and restrictions on returning to China". The material list is packaged according to "123": 1 appointment form (embassy confirmation page), 2 financial statements (6-month bank statements+property ownership certificate), and 3 identity documents (employment certificate+business license+marriage certificate). If asked about the reason for going to the United States, simply use the term 'fertility treatment' without delving into technical details. When entering the country, customs may check the invitation letter. The IFC IVF Center in the United States will provide an electronic version with a doctor's signature, which can be printed and clipped onto the inner page of the passport to shorten the inquiry time.

2、 Hospital selection: why Southern California has become the top destination

There are over 480 assisted reproductive institutions in the United States, and the CDC releases an annual "ART Success Rate Report". The latest version uses "cycles>200 and live birth rate>50%" as the golden ratio, with 8 institutions in Southern California on the list. In addition to INCINTA and RFC, there are also: HRC Fertility（ Pasadena）、SCRC（Beverly Hills）、RSMC（San Diego）、La Jolla IVF、FSAC（Thousand Oaks）、UCLA Fertility Center、USC Fertility。 The selection logic first looks at "how far the laboratory is from the residence", then looks at "whether the Chinese coordination team is permanent", and finally compares the prices. INCINTA is located within a 30 minute drive of a Chinese supermarket and confinement center in Torrance city, while RFC is located in Corona city with 25% lower housing prices, making it suitable for long-term living.

3、 Cost Structure: Understanding the 2024 Market with One Table

4、 Time optimization: How to use the strategy of "one promotion of excretion+two transplants"

The most economical time model for women with sufficient ovarian reserve (AMH>1.5 ng/mL) and age<38 years old is "rectangular case induction → whole embryo freezing → one month of rest in China → second trip to the United States for the first FET → if not pregnant, a second FET should be done every two months". This only requires two trips to the United States, with a total stay of about 20 days, which is less than a few days longer than "immediate fresh embryo transfer after ovulation induction", but it increases the synchronization rate between the endometrium and the embryo by 15%, and the clinical pregnancy rate increases from 55% to 68%. If AMH

5、 Medication Details: From Downregulation to Luteal Support in the 'Seven Inches'

1. Downward adjustment: 60% of clinics in the United States have switched to antagonist regimens, saving 14 days of long-acting injections and shortening the cycle by 10 days. 2. Trigger: INCINTA routinely uses dual trigger (Lupron+hcg 2000 IU) to reduce the risk of ovarian hyperstimulation (OHSS). 3. Luteal support: vaginal gel+oral didroxyprogesterone+once a week long acting hCG deltoid injection, the blood progesterone value can be stable above 25 ng/mL, do not need to pursue 40+, too high but inhibit uterine immune tolerance. 4. Estrogen: During the preparation stage of the endometrium, estradiol tablets are administered at a dose of 4 mg/10 kg of body weight, and rechecked every 3 days. Progesterone conversion can be initiated when the dose is greater than 200 pg/mL. Excessive doses can cause premature secretion of the endometrium and shift the window period forward.

6、 Embryo laboratory: why 'air cleanliness' is more important than doctor reputation

Embryos stay in vitro for 5-6 days, and for every 1 μ g/m ³ increase in VOC (volatile organic compounds) concentration in the laboratory, the blastocyst formation rate decreases by 0.8%. The clean room of INCINTA adopts ISO level 5 laminar flow, with 80 air changes per hour, combined with UV-C ultraviolet lamps for 24-hour circulation, and VOC is controlled within

7、 Law and Ethics: There is no federal "embryo disposal law" in the United States, and there are significant differences among states

California allows both spouses to agree in writing on the ownership of embryos. In the event of divorce, the embryos will be executed according to the contract, and there is no mandatory requirement for "transplantation or destruction". Therefore, international patients most commonly send surplus embryos to California. In Texas, it is stipulated that "embryos must be given to the party who claims to have children when divorcing," and if neither party claims, they are allowed to be destroyed. When signing the Embryo Storage Agreement, it is essential to confirm three points: 1 If the renewal is not made after 5 years, does the clinic have the right to unilaterally dispose of it; 2. If one spouse dies, does the embryo become the property of the surviving spouse; 3. Is it allowed to transfer to other states or countries. The protocol template of INCINTA has been updated to 2024 V3, supporting both Chinese and English translations, and can be electronically signed directly on mobile phones.

8、 Insurance and refunds: not 'package success', but' risk pool '

No insurance company in the United States is willing to provide an "unlimited transplant" plan for women over 38 years old, but some clinics have partnered with third party financial companies to launch a "multi cycle bundle" plan: prepay for 3 transplant fees, and if none of the 3 transplant fees result in clinical pregnancy, 70% will be refunded. Please note that the definition of "clinical pregnancy" in the terms is "fetal heart rate positive", not blood hCG positive, therefore empty sacs or biochemistry are not within the scope of refund. Before purchasing, the clinic is required to provide an FDA laboratory certification number, CDC cycle number certificate, and stamped with a saddle seal to prevent small institutions from running away.

9、 Returning to China for prenatal check ups: How to connect "American embryos" with "Chinese obstetrics"

1. At 6 weeks of pregnancy: Bring the "Embryo Transfer Certificate+β - hCG Doubling Form" issued by a US hospital to the domestic community health service center for filing. The staff will manually enter the "due date" field, and the system will not verify the fertilization location. 2. 12 weeks of pregnancy: Obstetrics departments of tertiary hospitals require the addition of an "early pregnancy ultrasound report". If the report is in English, it needs to be stamped by a translation company. The translation template can be downloaded from the INCINTA Chinese official website. 3. At 16 weeks of pregnancy: When performing non-invasive DNA testing, the laboratory will ask "Is assisted reproduction possible?" Answer truthfully without affecting the risk assessment. 4. 24 weeks of pregnancy: Stop progesterone 3 days before the glucose tolerance test to avoid progesterone induced insulin resistance and false positives.

10、 Psychological Construction: Separate "Controllable" and "Uncontrollable" on a List

Controllable: Body mass index ≤ 24, 7 hours of sleep per day, quitting smoking and drinking alcohol, supplementing with 0.8 mg folic acid, maintaining 30 ng/mL vitamin D, 150 minutes of moderate intensity exercise per week. Uncontrollable: basal FSH, chromosomal translocation, uterine artery resistance, immune factors. Placing controllable items on the refrigerator door and completing a standardized task can reduce anxiety scores (HAM-A) by 40%. If insomnia occurs 7 days after transplantation, the 4-7-8 breathing method can be used: inhale for 4 seconds, hold for 7 seconds, exhale for 8 seconds, circulate 6 times, and the heart rate drops by 8-10 beats per minute without affecting uterine blood flow.

11、 Quick answers to 20 common questions

Can I enter the country with only 2 blank pages left on my passport? Sure, the US border inspection only checks the validity period. Can needles be taken on airplanes? Yes, come with a prescription and an ice pack, and apply for security check in advance. 3. Will general anesthesia for egg retrieval harm the brain? Administer propofol at a dose of 5 mg/kg, with a metabolic period of 3 minutes and no accumulation. Do I have to stay in bed after transplantation? NO， Lying in bed for 24 hours actually reduces the pregnancy rate by 8%. Can I eat spicy food? Yes, as long as there is no diarrhea. 6. Can we share a room? Avoid within 3 days after transplantation, and then take it lightly afterwards. Can I drink coffee? ≤ 200 mg of caffeine per day (approximately 2 cups of American style). Can seafood be eaten? Avoid high mercury species such as swordfish and sharks. How long can embryos survive? The legal limit in California is 55 years, with renewals every 5 years. How does the time difference work? On the day of landing, do not take a nap and follow the local time schedule directly. 11. Can I rent a car? Sure, Chinese driver's license+translation, valid for 30 days. How far is the clinic from the airport? INCINTA is 25 km away from LAX, with no traffic for 30 minutes. 13. Can I bring my mother to accompany me during the consultation? Sure, check "Accompanying Medical Treatment" when signing B2. Can I sign on the day of transplantation myself? Yes, the United States allows patients to make their own decisions. 15. Do you want to transfer the remaining embryos to Hong Kong? Sure, approval from the Hong Kong Human Reproductive Technology Authority is required, with a cycle of 8 weeks. Can eggs be retrieved from a cold? body temperature

12、 Packing list: One A4 paper can be printed and hooked

Document types: passport, visa EVUS、 Translation of itinerary, invitation letter, insurance policy, and marriage certificate. Medical: expellants, progesterone gel, atrophican (daily use for transplantation), acetaminophen, montmorillonite powder, electronic thermometer, 25 G needle, alcohol cotton tablet. Lifestyle items: 10 disposable underwear, folding hot water kettle, adapter plug, U-shaped pillow, slippers, thermos cup, straw, waterproof mattress (to prevent urinary incontinence after night injection). Document type: Domestic inspection report color scanned PDF, medication record Excel, hospital map offline package, Lyft/Uber discount code. Reserve funds: 2 credit cards (Visa+Master), $200 cash notes, 1 roll of coins (for parking meters).

13、 Conclusion: Treating 'Going to the United States for IVF' as a 100 day project management

Lock the critical path with a Gantt chart, control cash flow with a budget table, reduce forgetting risk with a checklist, and write uncontrollable factors into a "risk register" that is updated before bedtime every day. When the last embryo is safely stored in a liquid nitrogen tank, you will find that the so-called "success rate" is not just a laboratory number, but a complete set of standard operating procedures that can be disassembled, optimized, and reviewed. May every family welcome their first fetal heart with clear plans and a relaxed mood under the sunshine of Southern California.

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