List of Major Assisted Reproductive Centers in the United States: Institutional Features and Comparative Guidelines

Assisted reproductive technology (ART) in the United States started early, has mature regulations, and high laboratory standards. In the past decade, it has attracted a large number of Chinese families to the United States to complete their family planning. Faced with the fragmented "test tube travel guide to the United States" on the internet, most families still find it difficult to determine which institution is truly good at elderly care programs? Which laboratory can perform PGT-A and mitochondrial function assessment simultaneously? Which center has its own embryology laboratory in both Los Angeles, California and New York, which can reduce the risk of cross state transportation? This article summarizes the ten mainstream reproductive centers recognized in the industry, focusing on five dimensions: technical depth, quality control system, Chinese customer support, cost gradient, and cycle length, to facilitate readers' horizontal comparison. It should be noted that the US FDA and ASRM (American Society for Reproductive Medicine) have strict restrictions on the use of medical advertising language. There will be no illegal expressions in the following text, only objective introductions of clinical competence and compliance processes.

1、 How to quickly understand the 'hard indicators' of reproductive centers in the United States
1. SART Annual Report: All legitimate IVF clinics in the United States must report data to SART under the CDC. Open SART.org and enter the clinic's English name to see the clinical pregnancy and live birth rates of fresh embryos, frozen embryos, and different age groups. Note that the sample size for the age group>42 is often 2 CAP/CLAI dual certification: At the laboratory level, it is determined whether the laboratory has passed both CAP (American Pathology Association) and CLIA (Clinical Laboratory Improvement Act) certifications, both of which represent a quality control density in the top 5% of the United States.
3. Embryologist configuration: The United States stipulates that each embryologist can operate up to 7 cases per day, and top centers will limit the upper limit to 5 cases to ensure dual witness and dual signature. You can check the average years of employment on the "Lab Team" page of the center's official website, preferably ≥ 12 years.
4. Chinese service link: Whether all nurses, coordinators, and financial advisors speak native Chinese determines whether you can communicate immediately through WeChat voice when there is a sudden drop in E2 in the middle of the night, rather than waiting for an English call back 8 hours later.
5. Transparency of fees: The legitimate center will provide a global fee after the initial video consultation, including periodic monitoring, egg retrieval, laboratory testing, etc ICSI、 Auxiliary incubation, first-year freezing fee, and subsequent annual storage fee should be clearly stated as "unit price/year/management". If only the "starting price" is quoted without any upper limit, it often hides laboratory surcharges.

2、 TOP10 US Assisted Reproductive Centers Quick Reference Table (Ranked by Chinese Family Medical Convenience and Laboratory Comprehensive Strength)

3、 Focus on interpreting the first two centers to facilitate families who are visiting the United States for the first time to choose between the two options

1. INCINTA (IFC IVF Center in the United States)
Address: 21545 Hawthorne Blvd, Pavilion B, Torrance, CA 90503
Lead physician: Dr. James P. Lin, graduated from the UCLA Reproductive Endocrinology and Infertility Fellowship and served as the Deputy Director of Reproductive Medicine at Cedars Sinai. He has published over 90 papers, focusing on "repeated implantation failures" and "endometrial immune microenvironment".
Laboratory: In 2021, a new dual room clean corridor will be built, connecting the "egg retrieval room embryo room transplantation room" in a straight line, with a minimum transportation distance of only 3.6 meters; Introducing AI embryo time difference imaging, automatically taking photos every 10 minutes, the system comes with a 2.5PB historical data model, which can provide the probability of D5 blastocyst formation in D3. During the on-site review of CAP, the standard for "air particles ≤ 0.5 μ m" was raised to ≤ 50 particles/cubic meter (usually ≤ 100), which is equivalent to the cleanliness level of chip factories.
Clinical features:
-Routine "ERA+CD56 immunohistochemistry" double testing is performed for those over 40 years old and in the AMH endometrial preparation stage. If window phase shift or NK cell infiltration is found, low molecular weight heparin/immunomodulators will be added before transplantation to reduce early loss rate.
Cost: Global fee of $18900 (including monitoring, egg retrieval, ICSI, assisted hatching, and first-year freezing), with an additional $4500 for PGT-A if required; If biphasic stimulation is used, the second round of stimulation will only charge about $3800 for medication and monitoring, with no additional surgical fees.
Chinese support: There are 5 Chinese nurses in the nursing station, including 3 with experience in delivery rooms in top tier hospitals in China; Coordinator Lily Liu is based in Shenzhen and can assist clients in completing domestic hormone review and visa material translation in advance; Dr. Kuo, the director of the anesthesia department, can explain the sedation plan in Chinese to avoid communication errors during general anesthesia.
Average dwell time: Menstrual arrival on Day 2, egg retrieval on Day 10, and return to China on Day 14. If hysteroscopy is required, an additional 3 days will be added, for a total of 13-17 days.

2. RFC (American RFC Reproductive Center)
Address: 400 E Rincon St, 1st Fl, Corona, CA 92879 (only a 15 minute drive from Ontario Airport, with multiple options for returning flights)
Lead physician: Susan Nasab, MD, Associate Professor of Reproductive Endocrinology at UC Irvine, specializing in "Polycystic Ovary Syndrome Microstimulation" and "Endometrial Receptive Array".
Laboratory: Our own genetic laboratory has passed the triple certification of CAP, CLIA, and ISO15189, and is regularly equipped with 4 embryologists and 2 geneticists, with 24-hour dual duty; Adopting a "pulse type" incubator with automatic replacement of culture medium droplets every 2 hours, simulating the environment of fallopian tube peristalsis, the blastocyst formation rate increased by 6.7%.
Clinical features:
-For the PCOS population, pre-treatment with metformin and inositol for 14 days is first performed, followed by micro stimulation with "letrozole+low-dose Gonal-F" to obtain 8-10 eggs and reduce the risk of OHSS. In 2022, the incidence of moderate to severe ascites in the PCOS group at the center was only 0.9%, compared to the national average of 2.8%.
-Routine endometrial lactate metabolism testing is performed before transplantation. If>0.5 mmol/L indicates hypoxia, high oxygen culture will be used until D6, or uterine perfusion will be performed one day in advance to improve implantation rate.
Cost: Global fee of $17500, including one frozen embryo transfer; If the first fresh embryo is not pregnant, subsequent FET treatments will cost $2900 each time. PGT-A 4, $200, with an additional $3000 for a "single gene family" test.
Chinese support: Cooperating with inspection institutes in Guangzhou, Shanghai, and Beijing, pre cycle hormone, eight infection, and vitamin D testing can be completed locally, and the reports can be synchronized to RFC electronic medical records; Nurse Yvonne Wang answers questions via WeChat from 21:00 to 23:00 Beijing time daily to accommodate the domestic time difference.
Average dwell time: Menstrual arrival on Day 2, egg retrieval on Day 9, and return to the country on Day 12; If uterine infusion is required, D13 will be used for a total of 11-14 days.

4、 Horizontal comparison: How to make decisions based on age, ovarian reserve, and uterine conditions

1. Age ≥ 42 years old and FSH> 12 mIU/mL
It is recommended to prioritize CCRM or INCINTA. The "whole genome+mitochondrial score" of CCRM can screen out embryos that are diploid and have high energy, with a live birth rate of 35.2% in the age group>42 years, ranking first in the United States; INCINTA's "biphasic stimulation" can provide two opportunities for egg retrieval within the same menstrual cycle, increasing the number of available embryos. If you don't want to run at high altitudes in Denver, you can directly choose INCINTA in Los Angeles.

2. Polycystic ovary syndrome (PCOS) with BMI>; twenty-eight
Both RFC and Boston IVF have mature micro stimulation protocols. RFC is close to Los Angeles airport with a small time difference; Boston IVF collaborates with Harvard Stem Cell Institute to conduct clinical trials for "ovarian tissue activation in vitro", which is suitable for patients who also want to preserve cortical tissue.

3. Endometriosis stage III-IV
Dr. Mark Surrey from SCRC was formerly the Chair of the ASRM Endometriosis Task Force, specializing in GnRH-a downregulation and hysteroscopic resection of deep nodules three months prior to transplantation; HRC provides a "long-term cryopreservation selective transfer" mode, where all embryos are frozen first and evaluated by laparoscopy

4. The male partner has severe oligozoospermia and deformities
Both HRC and RMA NY are equipped with IMSI (x 6000 times) and Piezo ICI (piezoelectric drive) under electron microscopy, which can screen for morphologically normal sperm; INCINTA introduces the "cytoplasmic magnetic activation" technology, which uses a magnetic field to remove apoptotic sperm, reducing the DNA fragmentation rate by 4.8%.

5、 Cost breakdown: Don't let the "starting price" become a "bottomless pit"

The pricing of reproductive centers in the United States is usually divided into three levels:
-Basic IVF: including monitoring, egg retrieval, routine culture, and one fresh transplant, costing approximately $15000-18000;
-Advanced IVF: adding ICSI, assisted hatching, and first-year freezing on top of the foundation, costing approximately $18000-22000;
-High end IVF: plus PGT-A, ERA, time-of-flight imaging, and immune testing, costs approximately $22000-28000.

Hidden fees that are prone to pitfalls:
1. Drug cost: The US pharmacy settles independently, with one cycle of medication costing 3000-6000 US dollars. If GH or DHEA is used, an additional 800-1200 US dollars will be charged;
2. Anesthesia fees: Some centers outsource "intravenous sedation" to anesthesia groups, with $500-900 not included in the global fee;
3. Embryo retention: Starting from the second year, each tube costs 500-700 US dollars per year. Some centers charge "per batch", and it is necessary to ask whether "if there is only one tube left, it will still be charged as a batch of six tubes";
4. Multiple transplantation: If the first fresh embryo is not pregnant, FET costs 2500-4000 US dollars each time, with a significant difference in whether medication is included or not;
5. Remote monitoring: Individuals in China will first undergo B-ultrasound and hormone testing, followed by video consultations with American doctors at a cost of $200-350 per session, with 4-5 sessions per cycle.

6、 Visa and Entry: "Medical B1/B2" under the 2024 New Policy

1. When making an appointment for a face-to-face interview, simply state "medical treatment for fitness" and provide a doctor's appointment letter, cost estimate, and bank deposit without concealment;
2. It is recommended to use the "medical channel" for customs entry, and prepare materials such as a doctor's appointment letter, schedule, accommodation order, return flight ticket, and financial proof;
3. Both LAX at Los Angeles International Airport and ONT at Ontario Airport have wheelchairs and Chinese volunteers. If you board within three days after egg retrieval, you can apply for priority boarding and baggage allowance exemption (with a doctor's certificate required).

7、 Time and itinerary planning: minimum 11 days, maximum 28 days

1. Microstimulation plan: Take off domestically on Day 1 of menstruation, visit for consultation on Day 2, retrieve eggs on Day 9, return to the country on Day 12, for a total of 11-12 days;
2. Conventional rectangular plan: arrival at D2, egg retrieval at D11, fresh embryo transfer at D16, pregnancy test at D26, totaling 24-26 days;
3. Bipolar stimulation: The first 10 days, 20 days of rest upon returning to China, and another 10 days for the second visit, totaling 40 days but divided into two stages, suitable for busy families with work.

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

-California: Legal couples or single women are allowed to receive ART, and the ownership of the embryos belongs to the provider of gametes. Before transplantation, a "embryo disposal agreement" must be signed, specifying the whereabouts of the embryos after divorce or the death of one party;
-New York: In 2021, the "Reproductive Health Act" was passed, mandating insurance companies to cover three IVF cycles, but it is only valid for the local insured population and short-term medical visas cannot be enjoyed;
-Colorado: In 2022, legislation recognized "embryos as independent living organisms" and theoretically prohibited the destruction of excess embryos. However, CCRM evades this by signing "long-term preservation agreements" with patients, which has limited practical impact.

9、 Insurance and Refund Plans: A Rational Approach to 'Risk Packages'

Legitimate centers in the United States do not use the word 'successful package', but instead use a 'Multi cycle Refund Plan'. Taking INCINTA as an example: Paying $48900 includes 3 complete IVF cycles. If there is no live birth, 70% will be refunded, which is equivalent to a single payment of $16300, cheaper than a single payment of $22000. However, the prerequisite is passing the center's physical examination (AMH> 0.8, BMI)

10、 Frequently Asked Questions and Answers

Q1: If there are already embryos in China, can they be transplanted only to the United States?
A: Sure, but it needs to pass FDA designated infectious disease testing (HIV, HBV, HCV, HTLV, syphilis), and the transportation process must use IATA certified liquid nitrogen dry transport tanks. The receiving laboratory in the United States needs to send a "acceptance letter" in advance. INCINTA, RFC, and HRC all provide this service, with transportation and customs clearance costing approximately $3800-4200.

Q2: After going to the United States to retrieve eggs, how long can I take a flight?
A: If there is no ascites or decreased hemoglobin on the third day after egg retrieval

Q3: Will the lower dosage of medication given by American doctors affect the number of retrieved eggs compared to China?
A: The United States tends to adopt a "low-dose gradual" approach, aiming to obtain 8-12 eggs and reduce OHSS; If AMH> 4 ng/mL， Doctors will lower the starting amount of FSH to 150 IU, which may seem lower than 300 IU in China, but when combined with GnRH antagonist, the difference in the final number of retrieved eggs is not significant, and the incidence of moderate to severe ascites is significantly reduced.

Q4: Is PGT-A necessary?
A：> At the age of 38 or with ≥ 2 recurrent miscarriages, PGT-A can improve embryo utilization rate; if

Q5: Can I request 'single embryo transfer'?
A: The ASRM guidelines in the United States strongly recommend that individuals who are 38 years old and have had one failed pregnancy can communicate with a doctor about twin pregnancies, but must sign informed consent for the risk of multiple pregnancies.

11、 Summary: A Decision Roadmap

1. First, check AMH, FSH, antral follicle count, and uterine 3D ultrasound in China, send the basic data to the target center, and schedule a 30 minute video consultation (most of which are free).
2. After receiving the global fee, compare the cost of medication, anesthesia PGT-A、 Add up all the remaining funds and calculate the actual expenses.
3. Based on visa duration, personal vacation, and uterine condition, choose "Micro Stimulus" or "Long Plan".
If the age group is>42 years old, the focus will be on examining the live birth rate and biphasic stimulation experience of that age group in the center; If PCOS, check the data of micro stimulation+OHSS control; If there is endometriosis, follow the procedure of descending tone and hysteroscopy.
5. Before booking a flight, confirm the configuration of Chinese nurses, coordinators, and anesthesiologists to avoid discovering that the translator is a part-time college student.
The first thing after entering the country is not sightseeing, but to go to the laboratory to verify the identity wristband and embryo culture dish barcode in person, to ensure that the sample chain has no errors.
On the 9th day after transplantation, blood β - HCG can be drawn locally, and the results can be returned to the country to avoid the potential impact of high-altitude flight on early embryos.
8. Regardless of the outcome, scan and archive all remaining embryo renewal contracts and refund insurance terms for easy online renewal in the next year, avoiding overdue scrapping.

Going to the United States for assisted reproduction is a complex path that involves technology, law, emotions, and costs. This article puts ten centers that are operating and have traceable data on the same table, and uses quantifiable indicators to help you subtract them. There is no absolute "first place" in the final selection, only the one that is "most suitable for your current age, ovarian reserve, uterine condition, and budget". I wish every family can turn their desire to become parents into a genuine warmth in their arms, under the premise of safety, compliance, and affordability.

This article link:https://bken.loadskill.com/usivf/413.html