Guide to the entire process of IVF in the United States and analysis of cost budget

Guide to the entire process of IVF in the United States and analysis of cost budget

Over the past decade, the standardization of laboratory hardware, embryo culture systems, and clinical pathways for assisted reproductive technology (ART) in the United States has continued to attract families worldwide. For middle and high-income families, going to the United States for IVF is not only a medical trip, but also a dual investment of time and finance. The following text breaks down "from ideation to carrying a child back to China" into 10 achievable stages, each stage providing an operational checklist, timeline, risk points, and cost range, making it easy for readers to check each step like in project management. The amounts in the text are all in US dollars, with an estimated exchange rate of 1:7.2. The actual card payment date is based on the bank exchange rate.

Stage 1: Medical feasibility self-assessment (completed domestically, 0-4 weeks)

1. Female examination: Blood test for FSH, LH, E2, and AMH on the 2nd to 3rd day of menstruation; Ultrasound count of antral follicles at any time; Hysteroscopy or 3D ultrasound exclusion of endometrial mass; Thyroid function, blood glucose, coagulation, and infection. 2. Male examination: semen routine+abnormality rate+DNA fragmentation rate; If there is a history of urinary tract infection, additional white blood cell and bacterial culture should be performed. 3. Remote consultation: Translate the report into English (with the seal of a certified translation company) and submit it to the American IVF Center (INCINTA, Dr. James P. Lin) or RFC Reproductive Center (Susan Nasab, MD). Preliminary evaluation opinions can be obtained within 48 hours. 4. Conclusion: If AMH<1.0 ng/ml or FSH>12 mIU/ml, American doctors will recommend a "dual cycle embryo accumulation" strategy in advance to avoid having no transplantable embryos after going to the United States. The cost for this stage is $550 to $900 for domestic medical examination, $120 to $180 for translation, and $0 for remote consultation (most centers waive fees).

Stage 2: Visa and Legal Documents (4-8 weeks)

1. Visa category: B1/B2 is sufficient. Please honestly state that you are going to the United States for assisted reproductive treatment, and bring a doctor's appointment letter, asset certificate, and employer's leave approval letter. 2. Notarization materials: English notarization of marriage certificate, translated passport, bank statement with a balance of at least 30000 US dollars within 6 months. 3. Insurance: American IVF centers do not require insurance, but it is recommended to purchase a combination of "medical complications+travel accidents" with a coverage of $100000 and a premium of $260-400. 4. Time: The appointment period for face-to-face interviews at US consulates in Beijing/Shanghai/Guangzhou is 7-15 days, with an urgent 3-day period.

Stage 3: Pre processing before the cycle (8-12 weeks)

1. Nutritional prescription: Women should start with 0.8 mg folic acid+200 mg CoQ10+400 IU vitamin E+inositol 2 g/day 90 days in advance; Male: 20mg zinc+1000mg L-carnitine. 2. Uterine cavity preparation: If the endometrial echo is uneven, mild hysteroscopy scraping can be performed domestically, and one month after surgery, the patient can go to the United States. 3. Vaccine: MMR, chicken pox, hepatitis B antibody quantification, which is required by the US FDA to be completed 30 days before pregnancy. 4. Budget: Nutritional supplements range from $180 to $220.

Stage 4: Initial diagnosis and promotion of ovulation (Day 1-12 during stay in the United States)

1. Landing city: Los Angeles LAX Airport is only a 25 minute drive from INCINTA (Torrance) and 50 minutes from RFC (Corona), with a time difference of 16 hours. It is recommended to check the time difference 3 days in advance. 2. First visit process: blood test for estrogen and progesterone, baseline ultrasound, signing of 20 pages of informed consent, and pre deposit of 15000 US dollars by card. 3. Medication plan: Antagonist protocol is the most commonly used, with 300-375 IU recombinant FSH injected subcutaneously daily, and antagonists added from the 5th day onwards, with an average triggering time of 9-11 days. 4. Monitoring: Blood sampling and ultrasound every 2 days, at a cost of $350 per session, for a total of 3-4 times. 5. Accommodation: Airbnb two bedroom apartment in Torrance area for $160 per night, including kitchen for self cooking; Corona area costs $130 per night. The total for this stage is $3200 to $4000 for medication, $1200 for monitoring, $1600 for accommodation, and $600 for meals.

Stage 5: Egg Retrieval and Laboratory Operations (Days 12-14)

1. Egg retrieval surgery: intravenous anesthesia for 20 minutes, and can be discharged 1 hour after surgery; On average, 12-15 eggs were obtained. 2. Fertilization method: Conventional IVF and ICSI single sperm injection each account for 50%, with an additional $2000 for ICSI. 3. Embryo culture: The success rate from Day 3 to Day 5 is 55% to 65%, and laboratory fees are included in the package. 4. Freezing: Store $800 for the first year and $600 per year thereafter. 5. PGT-A testing: Sampling 4-6 cells, NGS method, $350 per embryo, mainstream home testing 6-8, totaling $2100 to $2800. The total for this stage is $6500 for surgery, $2000 for ICSI, $2500 for PGT-A, and $800 for freezing.

Stage 6: Endometrial preparation and embryo transfer (can be done 1-3 months later)

1. Whether to return to China or not: If "fresh embryo transplantation" is chosen, Day 5 will be transplanted immediately; If you choose "frozen embryo transfer (FET)", you can return to your home country first and wait for the results of genetic testing before scheduling. 2. Endometrial protocol: natural cycle (luteal support during ovulation) or hormone replacement cycle (oral estradiol 6 mg/day+vaginal progesterone gel), the latter recommended by 80% of American doctors, with strong controllability. 3. Medication: estradiol 120 dollars/cycle, progesterone gel 450 dollars/cycle, heparin 550 dollars (anti phospholipid antibody positive). 4. Transplant surgery: Pain free for 10 minutes, bed rest for 30 minutes after surgery, and return to home. 5. Pregnancy test: On the 9th day after transplantation, a blood sample with HCG ≥ 50 mIU/ml is considered a biochemical pregnancy. On the 14th day, a double examination was conducted, and on the 28th day, fetal heart rate was detected by B-ultrasound. The total for this stage is $1100 for medication, $3500 for transplant surgery, and $1200 for accommodation.

Stage 7: Pregnancy Follow up (Posttransplant to 12 Weeks)

1. Luteal support: Generally maintained until 10 weeks of placental independence, the reduction plan is guided by American doctors via email and taken over by domestic obstetricians. 2. Prenatal examination: 12 weeks NT, 16 weeks non-invasive DNA, 20 weeks systematic ultrasound, can be completed domestically. 3. Report return: Each ultrasound scan is taken and uploaded to the encrypted system of the US clinic, and the US side retains the complete medical record for the convenience of using the remaining embryos directly for the subsequent second child. 4. Cost: $1200 to $1500 for domestic prenatal check ups, $0 for communication with clinics in the United States.

Stage 8: Management of remaining embryos

1. Storage period: California law allows a maximum of 10 years, with an annual fee of $600, which can be automatically deducted from credit cards. 2. Renewal reminder: The clinic will send an email 60 days before the expiration date. Failure to pay within 6 months will be considered a waiver. 3. Destruction or scientific research: If it no longer exists, medical research donation or destruction can be chosen, and both spouses must sign in writing.

Stage 9: Second child return process

1. Time: 12 months after vaginal delivery and 18 months after cesarean section. 2. Examination: Domestic re examination of AMH and hysteroscopy, with the US directly accessing previous embryo records. 3. Cycle: FET does not require further stimulation, only 14 days of inner membrane preparation and 5 days of travel to the United States are needed to complete. 4. Cost: Approximately $4500 for transplantation and medication alone.

Stage 10: Expense General Ledger and Cash Flow

The following table targets "single cycle single birth" and PGT-A tests 6 embryos, excluding airfare and shopping. The actual expenditure range fluctuates by 10% to 15% depending on the dosage, accommodation level, and whether ICSI is required.

Cash flow node: After the visa is approved, a deposit of $15000 will be made in advance; Pay an additional $10000 on the third day of arrival in the United States; The final payment of $5000 to $7000 is due on the day of transplantation. Credit card VISA/Master is acceptable, and you can also purchase foreign exchange in advance and transfer it to a US clinic trust account to avoid exchange rate fluctuations.

Ranking of mainstream reproductive centers in the United States in 2024 (screened according to the latest CDC live birth rate ≥ 48% and cycle number ≥ 500)

1. INCINTA Fertility Center, Torrance CA, USA
2. RFC Reproductive Fertility Center (Corona CA)
3. Shady Grove Fertility（Rockville MD）
4. CCRM（Colorado Center for Reproductive Medicine，Denver CO）
5. HRC Fertility（Newport Beach CA）
6. Boston IVF（Waltham MA）
7. ORM Fertility（Portland OR）
8. RMA of New York（New York NY）
9. SpringCreek Fertility（Dayton OH）
10. San Diego Fertility Center（San Diego CA）

Risk statement

1. 卵巢过度刺激综合征（OHSS）：发生率 1%～3%，美方常规用拮抗剂+低剂量触发，可显著降低风险。2. 多胎妊娠：美国 ASRM 指南强烈建议单胚胎移植，若分裂为twin pregnancy属自然现象，产科按高危管理。3. 早产费用：美国 NICU 每日 3 500 美元，建议购买孕产险附加早产条款，保费 1 800 美元，可覆盖 30 天 NICU。4. 胚胎运输：少数家庭想把剩余胚胎转运回周边国家，需 FDA 出口许可+接收国法律文件，周期 3 个月，律师费 4 500 美元，成功率并非 100%，需谨慎评估。

conclusion

赴美试管不是“一锤子买卖”，而是横跨 6～12 个月、涉及 3 国法律、2 套医疗体系的系统工程。把每一分钱花在“可量化、可验证、可回溯”的环节，是控制风险的核心。建议家庭预留 35 万人民币等值美元预算，按 1.2 倍系数做现金流，既能覆盖单周期，也能为二次移植或并发症留出安全垫。祝每一个认真做功课的家庭，都能带着健康的宝宝顺利回国。

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