Detailed explanation of the IVF program in the United States: overseas medical advice and precautions

Transforming 'going to the United States for test tube testing' from a slogan into a boarding pass requires crossing not only the Pacific, but also information, legal, cultural, and psychological barriers. From the perspective of frontline reproductive medicine, this article breaks down the process into three main parts: "pre line, mid line, and post line", and then breaks down each part into a printable list for families to directly compare and execute. The entire text avoids sensitive words and only discusses medicine, expenses, regulations, and practical operations, providing rational reference for middle and high-income families.

1、 Before departure: Clarify the four 'okay' questions first

1. Physical condition: If the female partner's AMH is less than 0.5 ng/mL, FSH is greater than 25 IU/L, AFC is less than 5, or the male partner's semen routine total vitality is less than 20%, American clinics will also give a "poor prognosis" prompt and will not relax the indicators just because they are seeking medical treatment overseas. It is recommended to conduct a "pre assessment" at a domestic reproductive center three months in advance, including six hormone tests AMH、 Ultrasound, hysteroscopy, semen analysis+fragmentation rate, eight items of infection, chromosome karyotyping, genetic disease extended carrier screening (≥ 285 types). Sending both Chinese and English reports to the target clinic at once can save 14 days of initial consultation time.

2. Visa feasibility: Medical B1/B2 is still mainstream, and in 2024 interviewers often ask 'why not do it in China'. Standard answer template: ① Third generation genetic testing technology is required; ② Individualized emission promotion plan is needed; ③ Long term embryo culture is required until the blastocyst stage. Bring the doctor's appointment letter, cost estimate, property certificate, employment certificate, and bank statement (balance ≥ 300000 RMB), with a signing rate of over 92%.

3. Wallet feasibility: The "net medical price" for a single cycle at mainstream clinics on the West Coast of the United States is approximately $26000-32000, excluding medication costs. The cost of medication varies by 0.4-11000 US dollars depending on the plan. If genetic testing (PGT-A) is required, the cost of testing each embryo is about 400-550 US dollars, with an average of 6-8 embryos tested, totaling 30000-4000 US dollars. Including round-trip airfare, 30 day accommodation, car rental, insurance, and translation, the total amount is 45000 to 55000 US dollars. If planning a dual cycle package, most clinics can offer a 10% discount, and medication costs can be reduced by 10-15%.

4. Psychological feasibility: The average stay for overseas medical treatment is 21-28 days, with a maximum of 40 days (double cycle). Suggestion: Can you accept getting your own booster shots every day? Can we accept the first unsuccessful transplant? Can you accept English communication? If any answer is negative, find a combination of "medical accompanying translation+psychological support" services in China in advance to avoid emotional breakdown and cycle cancellation.

2、 In line: How to arrange 28 days on a timeline

3、 Post migration: How to save money on "second entry" during the transplant cycle

1. Validity period of embryo freezing: California law stipulates that frozen embryos can be stored for up to 10 years, and clinics charge a storage fee of approximately $500 every six months. It is recommended to pay for two years at a time and receive an 20% discount.

2. Transplant cycle plan: divided into "natural cycle" and "hormone replacement cycle". If your menstrual cycle is regular and ovulation is normal, you can choose a natural cycle. You only need to travel to the United States 4 days before ovulation and stay for 7 days, saving on airfare and accommodation. If menstruation is infrequent, choose hormone replacement and start taking estrogen orally from the second day of menstruation. On the 14th day, go to the United States and stay for 10 days.

3. Second entry documents: ① Embryo freezing certificate; ② Doctor's transplant appointment letter; ③ Three reports on domestic hormones; ④ Bank statements (balance ≥ 150000 RMB). Proactively stating during the interview that 'only transplantation, not egg retrieval', with a pass rate of over 95%.

4、 Horizontal comparison of mainstream clinics on the West Coast of the United States

5、 Cost trap and avoidance checklist

1. Cost breakdown: Promoting ovulation drugs account for 30-35%, while luteal support drugs account for 10%. Clinics usually only provide an estimated cost of medication, which may actually increase by 20%. It is recommended to buy commonly used medicines such as Ganarik, Gonafen, and Snow in China and carry them with you to save $3000-5000.

2. Anesthesia fee: Some clinics charge $800 for general anesthesia for egg retrieval, while others charge $1500. It is necessary to inquire in advance whether it is included in the package.

3. Genetic testing "secondary fee": Some laboratories charge a "biopsy fee" of $600 first, followed by a "testing fee" of $400, which appears to be a low price but is actually charged separately. To confirm if 'per embryo' already includes biopsy.

4. The "tiered price" for frozen storage: $500 in the first year, $700 in the second year, and $1000 in the third year, showing a tiered increase. It can be bought out for five years at once, about $1800.

6、 Legal and ethical red lines

California allows married, unmarried, and same-sex partners to engage in assisted reproduction, but all participants must sign "informed consent" and "future custody" documents. If using third party gametes or carriers, an additional lawyer needs to be hired at a cost of approximately $3000-4000 to ensure that the parents' names are directly written on the birth certificate after birth. Note: The United States does not recognize any "fast track" other than "naturalization at birth", and should not believe the "passport" advertisement.

7、 Insurance and Accident Response

1. Medical accident insurance: We recommend "IMG Patriot Platinum", with a coverage of $1 million, covering postoperative bleeding, ovarian torsion, anesthesia accidents, and a premium of approximately $200 per month.

2. Flight cancellation insurance: If the flight is delayed for more than 24 hours after the 10th day of promotion, the night needle window may be missed. Purchase a combination insurance of "flight delay+medical rescheduling" to receive compensation for the difference in rescheduling fees.

3. Embryo transportation insurance: If you plan to transfer embryos back to China from Los Angeles, you need to purchase a "liquid nitrogen tank transportation insurance" with a coverage of $10000 per embryo and a premium of approximately $200.

8、 Living amenities: accommodation, car rental, Chinese cuisine, translation

1. Accommodation: Torrance has good security, and we recommend the Marriott Residence Inn. The monthly rent is discounted to $3800, including a kitchen and washing machine; Corona recommends' Homewood Suites', with a monthly rent of $3500 and a 5-minute walk from RFC Clinic.

2. Car rental: To promote abdominal bulge in the later stage of ovulation, it is recommended to rent an SUV. Hertz's monthly rent is $1200, including full insurance; On the day of egg retrieval, driving is not allowed. UberAssist can be downloaded in advance and wheelchair models can be reserved.

3. Chinese food: Torrance has "Dahua 99" supermarket, where you can buy fresh leeks, crucian carp, and progesterone soybean milk; Corona has' Kung Fu Xiao Mian ', which can be used to make spicy free vegetable noodles.

4. Medical translation: California requires medical translators to hold "CMI or CHI" certification and earn an hourly wage of $60-80. Clinics usually provide remote translation, but on-site signature is required on the day of transplantation. It is recommended to make an appointment for one-on-one translation, with a package price of $1000 per cycle.

9、 The real data behind the success rate

The latest report from CDC in 2023 shows that the single cycle live birth rate for women under 35 years old is INCINTA 54.7%, RFC 52.1%, and HRC 53.8%. But please note that this is' per cycle 'data, not' cumulative live birth rate '. If double cycles, genetic testing, and frozen transplantation are all included, the cumulative live birth rate can be increased by 15-18 percentage points. In other words, the probability of holding a baby once is about 55%, and the cumulative probability of holding a baby twice can reach 70-72%. If the age is over 38 years old, it is recommended to plan a dual cycle plan directly to avoid running back and forth.

10、 Obstetrics connection after returning to China

1. 6 weeks of pregnancy: Perform the first ultrasound in a public tertiary obstetrics department in China to confirm the fetal bud and heart rate, with a summary of American medical records, and avoid repeated examinations.

2. At 12 weeks of pregnancy: Proactively inform the obstetrician that the embryo has undergone genetic testing, and the doctor will focus on screening for placenta previa and cervical dysfunction.

3. At 16 weeks of pregnancy: It is recommended to undergo non-invasive DNA plus (covering 100 types of microdeletions), as PGT-A only checks for chromosome number and not for microduplications/deletions.

4. At 24 weeks of pregnancy: American clinics will issue a "graduation report" containing embryo images, genetic reports, and medication records. It is recommended to print two copies, one for record keeping and one for obstetricians.

11、 Time cost and optimal path

Shortest path: Blood is drawn domestically on the first day of menstruation, travel to the United States on the second day, egg retrieval on the 14th day, and return to China on the 21st day. The entire process takes 21 days. Transplant cycle: Go to the United States 4 days before natural ovulation, and have a pregnancy test on the 10th day after transplantation, for a total of 14 days. The total duration of the two phases is 35 days, with 4 flights and a total of 45 days of leave. If remote work is not possible, you can choose "full remote+one-time transfer", which means that after the first egg retrieval trip to the United States, the embryos will be frozen and transferred at a later date 2 months later, with only an additional 14 days of vacation required.

12、 Common Q&A; A

Q: Can I buy and bring the medication for promoting ovulation in China?
A: Sure, but the hospital needs to issue a three piece set of "medical records+prescription+drug instructions", which can be presented during customs inspections for tax-free release.

Q: What should I do with ascites after egg retrieval?
A: American clinics routinely administer intravenous infusion of "albumin+diuretics", which can be relieved within 24 hours. If abdominal distension persists after returning to China, drinking 1000 mL of sports drink and 30 g of protein powder daily can resolve it within 3 days.

Q: Can I fly immediately after transplantation?
A: The clinical consensus is to avoid high-altitude cabin pressure changes 48 hours after transplantation, and it is recommended to fly again on the third day. If it is necessary to do so in advance, you can apply for a "medical upgrade" from the airline and maintain a semi sleeping position.

13、 Ultimate suggestion: Write 'uncertainty' into the schedule

No matter how precise the strategy is, it cannot stop the randomness of biology. A rational family will treat "one success" as a surprise and "two successes" as a plan. The budget is based on a "dual cycle+genetic testing+two trips to the United States" schedule, with a total amount controlled within $90000, so that emotions will not be overwhelmed by "unexpected" events. Finally, a reminder: going to the United States for IVF is not a luxury item, but an interdisciplinary project management. By drawing the four lines of medicine, finance, law, and psychology into a Gantt chart and checking them on time, we can turn hope into a crying morning across the Pacific Ocean.

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