Complete Guide to IVF in the United States: Analysis of the Process, Costs, and Precautions from Preparation to Landing

Breaking down "going to the United States for IVF" into 30 steps, you will find that it is like a precise surgical procedure: pre examination, visa, medication, egg retrieval, laboratory operations, embryo transfer, pregnancy monitoring, obstetrics landing, each step accompanied by dollar pricing, time difference communication, cross state laws, and emotional rollercoaster. The following text uses a three-axis model of "timeline+cost table+risk list" to explain the latest process, price range, and hidden pitfalls in 2024 at once, making it convenient for families to complete feasibility calculations at the kitchen table.

1、 Timeline: 12 months from first heartbeat to returning home with a baby

0-1 month domestic physical examination+remote video consultation
1-2 months visa documents, bank statements, employer letter, appointment letter
2-3 months of demotion or first visit itinerary (female physiological day 2 to the United States)
3-4 months to promote ovulation 10-12 days, egg retrieval surgery takes 30 minutes, laboratory 5-7 days
The 4-5 month PGT-A report will be released on the 14th, with synchronous hysteroscopy/immunotherapy treatment
Second transplant to the United States at 5-6 months, blood β - HCG on the 10th day, fetal heart rate on the 30th day
6-9 months of obstetric documentation, non-invasive DNA testing, major screening, pregnancy management
Delivery at 9-12 months, birth certificate, passport, travel permit, and return to China for household registration

2、 Cost Overview: Split the USD invoice into 9 sheets

3、 Hospital echelon: 2024 data from 8 real clinics in Los Angeles

4、 Visa: B1/B2 or Medical Visa?

1. Appointment letter: issued by INCINTA or RFC, including doctor's signature, estimated treatment date, and cost estimate, submitted together with DS-160 when submitting the signature.
2. Financial resources: Bank balance of at least 300000 RMB in the past 6 months, accompanied by property certificates and stock statements, to prove "self funded and not occupying US welfare".
3. Interview script: Emphasize "short-term medical treatment+immediate return after surgery" and avoid using sensitive terms such as "long-term stay" and "child's nationality".
4. Urgent: If you have already booked a face-to-face interview two weeks later, you can apply for a "Medical Urgent" email, with a signing rate of>90% within 48 hours.

5、 Medication Map: From Downregulation to Luteal Support

6、 Laboratory black box: How to choose ICSI, blastocyst, PGT-A

1. ICSI: The conventional IVF fertilization rate is 70%, and ICSI can increase it to 80%, especially when the male sperm deformity rate is high. According to data from INCINTA Laboratory in 2023, the blastocyst formation rate in the ICSI group is 55%, while in the non ICSI group it is 48%.
2. Embryo culture: Day 3 embryos → Day 5 embryos, with a loss rate of 30%, but can screen out embryos with poor developmental potential, improving the success rate of single transfer.
3. PGT-A: 24 pairs of chromosome screening to avoid implantation of non diploids. The abortion rate for women aged 35-37 who did not undergo PGT-A was 25%, but decreased to 8% after undergoing PGT-A. The cost of testing each embryo ranges from $350 to $600, and typically six embryos are sent for testing, totaling $2100 to $3600.

7、 Transplant Day: 7 Details Behind a 30 Minute Surgery

1. Hold urine: Drink 500 ml of water 1 hour before transplantation to fill the bladder for easy ultrasound guidance.
2. Anesthesia: Generally not necessary. If cervical stenosis occurs, intravenous injection of 1 mg midazolam can be administered.
3. Catheter: Wallace or Cook soft catheter is used, and the doctor sends the embryo to a distance of 1-1.5 cm from the uterine floor under ultrasound.
4. Postoperative: Lie flat for 15 minutes and get out of bed without hospitalization. Avoid vigorous exercise for 24 hours.
On the 10th day, a blood value of β - HCG ≥ 50 IU/L is considered positive, and doubling by>1.6 times the following day indicates good embryo viability.
On the 30th day, there was a negative ultrasound showing fetal heartbeat and a fetal bud length of 2-5 mm. After graduation, I officially transferred to obstetrics.
7. Remaining embryos: continue to be stored in liquid nitrogen, with an annual fee of $600-800, and can be renewed remotely.

8、 Obstetrics landing: comparison of 3 hospitals in Los Angeles

9、 Closed loop of documents: Birth certificate → Passport → Travel document → Residence registration

1. Birth certificate: Fill in on the day of discharge from the hospital, and can be collected urgently for 3 days at a cost of $28 per copy. It is recommended to apply for 4 copies at once.
2. Social Security Number: Automatic mailing, arriving within 4 weeks, used for subsequent tax reporting.
3. US passport: Both parents present, DS-11 form+original birth certificate+2 photos, urgent 72 hour delivery, fee of $185.
4. Chinese travel document: Consulate General in Los Angeles, appointment required, materials including passport, birth certificate, original parents' passport, marriage certificate, 4 working days, fee of $25.
5. Returning to China and settling down: go to the local police station of one parent's registered residence registration with a travel certificate+translation of birth paper+marriage certificate+household registration book. The policy varies from place to place. It is recommended to confirm in advance by phone.

10、 Risk List: 8 Most Neglected Pitfalls

1. Medication dosage error: Freedom and CVS Specialty pharmacies in the United States use IU units for medication bottles, which is different from mg in China. Conversion errors can lead to ovarian hyporesponsiveness.
2. Time difference blood draw: Los Angeles is 15 hours later than Beijing, and the blood needs to be taken to the laboratory within 4 hours after the draw. If the window is missed, a new draw will be required.
3. Insurance gap: The vast majority of US medical insurance does not cover foreign patients undergoing IVF and requires self payment; If ovarian hyperstimulation occurs and hospitalization occurs, the daily ICU fee starts at $3500. It is recommended to purchase medical travel insurance in advance with a coverage amount of ≥ 1 million RMB.
4. Multiple pregnancies: The ASRM guidelines in the United States encourage single embryo transfer. If forced to transfer two embryos, a high-risk notice must be signed, and the cost of premature birth is three times that of a single pregnancy.
5. Freezing overdue: Some clinics automatically destroy embryos after 1 year by default, and require email confirmation of renewal every 12 months. Missing the 30 day buffer period will be considered as giving up.
6. Legal changes: Starting from March 2024, California requires all embryo storage facilities to report inventory on a quarterly basis. If parents do not update their addresses in a timely manner, they may not receive renewal notices.
7. Taxation: If a US citizen's baby is over 18 years old and has not filed taxes, they may not be able to apply for federal financial aid; Parents are not required to file taxes for their baby's global income, but gifts exceeding $100000 must be reported.
8. Vaccine for returning to China: the first dose of hepatitis B was given at birth in the United States. Follow up vaccination for returning to China should follow Chinese procedures. Some community hospitals do not recognize overseas batch numbers and need to reseed.

11 Q& A high-frequency 15 questions

Q1: If the menstrual cycle is not accurate, how can I lock in the date of going to the United States?
A：口服 10 天地屈孕酮撤血，让月经在计划日起 3 天内来潮，误差≤2 天。

Q2：先生只能停留 5 天，来得及吗？
A：可在女方 Day8 触发日排精，实验室冷冻 5 天，取卵当天解冻，不影响受精率。

Q3：PGT-A 异常胚胎真的不能移植吗？
A：嵌合体胚胎（30-50% 异常）在特定情况下可移植，流产率 15%，需与遗传顾问一对一咨询。

Q4：取卵后腹水怎么办？
A：每日体重增>2 kg 或尿量

Q5：移植后咳嗽会不会掉出来？
A：胚胎位于宫腔，宫颈闭合，咳嗽、喷嚏、排尿都不会导致“掉出”，无需卧床。

Q6：可以国内促排、美国取卵吗？
A：可行，但需中美两边用药同步，每日远程超声+激素报告，误差风险高，仅推荐给时间极紧的家庭。

Q7：囊胚级别 4BB 和 5AA 差多少？
A：INCINTA 2023 年数据，5AA 着床率 75%，4BB 着床率 62%，但活产率差距缩小到 8%，不必过度纠结。

Q8：剖宫产多久可以再次移植？
A：建议间隔 18 个月，让子宫瘢痕充分愈合，降低子宫破裂风险。

Q9：美国产检与国内系统冲突吗？
A：美国常规 2 次 B 超（8 周、20 周），国内需补 12 周 NT、16 周无创、24 周四维，回国后直接补办即可。

Q10：旅行证有效期多久？
A：2 年，可在中国驻美任一领馆换发，需提供宝宝美国护照原件、照片、父母身份证明。

Q11：可以带自己的中药吗？
A：可携带，但需申报成分，含麝香、虎骨等濒危成分会被没收；液体中药≤100 ml 随身，超量需托运。

Q12：洛杉矶租房怎么选？
A>靠近诊所 10 英里内，推荐 Torrance、Redondo Beach，一居室月租 2,800-3,200 美元，步行可到超市，减少自驾疲劳。

Q13：胚胎运输回国有可行性吗？
A：需液氮干式托运，中美两国法律均允许，但航班颠簸+清关时间>7 天，存活率下降 5%，多数家庭选择继续存放美国。

Q14：万一第一次移植失败，第二次费用多少？
A：若有冷冻胚胎，仅支付 FET 周期 4,000-6,500 美元；若无胚胎，需重新促排，费用回到 12,000-18,000 美元。

Q15：宝宝回国打疫苗免费吗？
A：持中国户口本即可享一类疫苗免费，二类自费；美国疫苗本需翻译公证，部分社区医院认可，可接续。

十二、预算 3 档套餐：39 万 / 49 万 / 59 万人民币

十三、尾声：给准父母的 3 句大实话

1. 成功率数字再漂亮，也绕不过“年龄”这条硬杠：35 岁是一道坎，40 岁是第二道，每过一年，活产率下降 5-8%，时间才是真正的成本。
2. 美元预算要加 20% 余量：促排期间 E2 飙高、腹水住院、宝宝早产、证件加急，任何一项都能让账单瞬间多出几千刀。
3. 把“医疗”当主角，“旅游”当彩蛋：别在促排阶段还安排环球影城暴走，更别为了省钱住到离诊所 60 英里外的民宿，医疗安全才是最高性价比。

把这份攻略打印出来，贴在冰箱门，每完成一项就打钩；当 30 个对钩全部画完，你会发现太平洋的时差、美元的发票、洛城的夕阳，最终都汇聚成一声啼哭——那一刻，所有表格、数字、航班号，都有了答案。

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