Detailed explanation of the cost of in vitro fertilization in the United States: a list of expenses for each step

Breaking down the question of "how much does it cost to go to the United States for IVF?" is actually like dismantling a precision instrument: the outer shell may seem like a total price, but the interior is composed of more than a dozen independent and stackable micro modules. As long as there is a variable in one of the links - age, medication response, number of embryos, whether anesthesia is needed, whether insurance is used, whether cross state travel is required - the bill will be layered like dominoes. The following text takes "a complete cycle" as the axis and spreads out every possible payment node, providing the real charging range of the two mainstream medical circles in Los Angeles and San Francisco in 2024, and attaching a printable "cost quick check table" to facilitate families to make cash flow budgets before going to the United States.

1、 Before the cycle: The 'invisible threshold' that needs to be spent before entering the week
1. Domestic pre examination: RMB 4000-8000
Clinics in the United States only recognize laboratory reports that meet CAP certification, but in order to allow doctors to assess in advance whether it is worth a visit, most families in China will first list the six hormones AMH、 Chromosome karyotype, hysteroscopy, and semen analysis have been completed. As long as the English stamped report is issued in the laboratory of a tertiary hospital or chain laboratories such as Jinyu and Dean, American doctors generally accept it and can offset the basic examination fee of $1000-1500 in the United States.

2. Remote video consultation: $250-350 per session
INCINTA, RFC and other top clinics offer Zoom initial consultations, with a duration of 30 minutes and including Chinese translation. If a written pre treatment plan from a doctor is required, an additional $150 will be charged.

3. Visa and itinerary: $1600- $2200 per person
B1/B2 visa fee of 185 USD; If an urgent appointment is required, the service provider charges $150-300; Round trip economy class costs 8000 to 10000 yuan during the off-season, and goes straight to 15000 yuan during the peak season; An additional $120-180 is charged for one transit within the United States.

2、 Cycle initiation: What exactly is included in the hospital's "fixed price" package
The mainstream clinics on the West Coast of the United States package the "single autologous fresh cycle" as Global Fee, which may seem transparent, but in reality, the length of each clinic's catalog varies. Here are two centers with the largest number of family visits in China as examples:

INCINTA Fertility Center (IFC IVF Center in the United States)
Doctor service fee: $5900 (including ultrasound monitoring, egg retrieval surgery, and transplantation surgery)
• Laboratory section: $8400 (fertilization, embryo culture, laser assisted hatching, blastocyst scoring)
Anesthesia fee: $750 (intravenous anesthesia, charged based on 30 minutes)
• Drug cost: $3200- $5800 (GnRH antagonist regimen, estimated based on 10-12 days of ovulation promotion)
One year embryo freezing: $1200 (including first year storage, $600/year thereafter)
PGT-A testing: $5800 (including biopsy of 8 embryos+NGS, $275 for more than one embryo)
Package total: $25250-27450 (excluding lower limit of medication) → $28450-31650 (including upper limit of medication)

Reproductive Fertility Center (RFC Reproductive Center, USA)
Doctor service fee: $5500
• Laboratory: $7900
Anesthesia: $650
• Drug cost: $2900-5400
One year of freezing: $1000
PGT-A: $5500 (up to 6 embryos, exceeding $250 per embryo)
Total: $23550-25550 (without medication) → $26450-30950 (with medication)

3、 Drug cost: the most uncontrollable "X" variable in the bill
Reproductive drugs in the United States are monopolized by three major companies: Merck, Olaf, and Fresenius. The pharmaceutical factory adjusts prices twice a year in March and October, with a range of 3% -8%. Taking the most common "antagonist regimen" as an example:

Unit price of project dosage, subtotal of cycle dosage
Gonal-f RFF 900 IU 900 IU 1050 USD/tube 3-4 tubes 3150-4200 USD
Menopur 75 IU 75 IU $87/tube 10-15 tubes $870-1305
Cetrotide 0.25 mg 0.25 mg $105/tube 4-5 tubes $420-525
Ovidrel 250 μ g 250 μ g $125 per unit $125 per unit
Total: $4656-6155

If the patient's AMH is greater than 5 ng/ml, the doctor may switch to "micro stimulation" or "natural cycle", and the medication cost can be reduced to $1200-1800; If AMH<0.5 ng/ml, a long-term plan and dual board trigger are required, and the cost of medication will skyrocket to over $7000.

4、 Lab upgrade options: do or not do, price difference of $3000-8000
1. Time lapse imaging of embryos: $1200- $1500
2. Magnetic screening sperm (MACS): $600
3. Embryo extension culture until Day 7:400 USD
4. Second egg retrieval surgery (double retrieval in the same cycle): $3800 (including anesthesia)
5. Sperm cryopreservation: $550 per session, followed by $400 per year thereafter

5、 Genetic screening and diagnosis: how to choose PGT-A, PGT-M, PGT-SR
PGT-A (non diploid screening) is the most commonly selected item, and the charging logic is based on the "number of embryos" tiered pricing:

Number of embryos INCINTA RFC remarks
1-6 pcs $5800 $5500 including biopsy+NGS+report
7-12 pieces, $6900, $6500. Each additional piece costs $275
12 samples priced at $8200 and $7800 require biopsy in 2 batches

If one spouse carries a monogenic disease (such as thalassemia or spinal muscular atrophy), an additional PGT-M is required, costing an additional $4500 to $6000; PGT-SR for chromosome balanced translocations costs $5000 to $7000.

6、 Freezing and storage: The longer the time, the higher the compound interest
Clinics in the United States generally package the "first-year freezing fee" into the total cycle price, but from the second year onwards, it is charged on a "per tube" basis. Taking INCINTA as an example:

• 胚胎冷冻：600美元/年（不限管数）
• 精子冷冻：400美元/年
• 卵子冷冻：700美元/年

如果10年后才回来移植，仅冷冻费就6 000美元，接近一个新鲜周期的四分之一。

七、移植阶段：一次不成，后续怎么收费
1. 冷冻胚胎移植（FET）
医生费：2 200–2 800美元
实验室：1 500–1 800美元
药费：雌二醇+黄体酮，400–700美元
合计：4 100–5 300美元/次

2. 内膜免疫检测（ERA、EMMA、ALICE）：1 400美元
3. 宫腔镜复查：2 200–3 500美元（若发现粘连、息肉，同时手术再加2 000美元）

八、麻醉、手术与病理：容易漏掉的“小尾巴”
美国麻醉师与手术中心是独立账单。以取卵为例：

• 麻醉医生：650–900美元
• 手术中心占用：1 200–1 800美元（按1小时计算，超时270美元/15分钟）
• 病理化验（息肉、内膜活检）：300–600美元

九、保险：能不能报？能报多少？
1. 加州、纽约、马萨诸塞、伊利诺伊等州强制保险公司覆盖不孕症治疗，但“覆盖”不等于“全免”。以Anthem Blue Cross PPO为例：

• 药费：自付30%，上限3 000美元/年
• 手术：自付20%，免赔额500美元
• PGT：不覆盖，需自费

2. 国际患者可购买的“医疗险”实为折扣计划，如Progeny、Future Family，年化利率5%–8%，可分期12–60期，但总利息接近本金的18%。

十、生活成本：洛杉矶 vs 旧金山 vs 拉斯维加斯
以30天停留计算（取卵15天+移植15天）：

城市 住宿（公寓式酒店） 交通（租车+油） 餐饮 合计
洛杉矶 150美元/晚×30＝4 500 700美元 1 800美元 7 000美元
旧金山 220美元/晚×30＝6 600 800美元 2 200美元 9 600美元
拉斯维加斯 120美元/晚×30＝3 600 600美元 1 500美元 5 700美元

若选择“两次短期往返”，每次15天，可省掉一半住宿，但机票从1 200美元涨到2 000美元。

十一、翻译与法律：两份文件最容易被加收
1. 病历翻译：中文→英文，150–200美元/套（含公证）
2. 胚胎运输授权：如需把剩余胚胎从美国转回国内，律师公证+FedEx干冰运输，2 800–3 500美元/次

十二、真实总账：三种常见场景速算
场景A：32岁，AMH 2.5，一次新鲜周期，无PGT，1次移植即妊娠
医院套餐：26 000美元
药费：4 000美元
生活：7 000美元
机票+签证：2 000美元
总计：39 000美元（≈28万人民币）

场景B：38岁，AMH 1.1，需PGT-A，取2次卵，3次移植
第一次周期：28 000美元
第二次取卵：12 000美元（仅手术+实验室+药）
PGT-A：6 500美元
3次FET：5 000×3＝15 000美元
生活：两次赴美共60天，14 000美元
总计：75 500美元（≈54万人民币）

场景C：42岁，AMH 0.4，采用微刺激+多次累积，共3个周期
每周期药费降到1 500美元，但取卵3次、PGT-A 3次、FET 4次
医院：24 000×3＝72 000美元
药：1 500×3＝4 500美元
PGT-A：7 200美元
4次FET：20 000美元
生活：90天，21 000美元
总计：124 700美元（≈90万人民币）

十三、如何把钱花在刀刃上：五点实战建议
1. 让医生在视频阶段就给出“预计促排天数”，药费误差可缩小到±15%。
2. 若子宫环境良好，可把新鲜胚胎全部冷冻，等回国休整后再赴美做FET，省下半个月住宿费。
3. 购买处方药时，先用GoodRx比价，再让诊所把处方发到Costco Pharmacy，Gonal-f一支可省200美元。
4. 选择“包年冷冻”而非“按管计费”，当胚胎管数≥4时，前者立省30%。
5. 若预计需多次移植，可一次性购买“3次FET套餐”，RFC报价11 000美元，比单次累计便宜4 000美元。

十四、可打印的“费用速查表”（单位：美元）

十五、结语：数字背后，是对时间与情绪的管理
美国试管费用之所以“高”，并不在于某一单项天价，而在于“可叠加项”太多。把每一分钱拆开来看，其实都与成功率曲线一一对应：多一次取卵，就多一份胚胎；多一次PGT，就多一道筛选；多一次FET，就多一次着床机会。学会提前做现金流模型，把“可能发生的第二次、第三次”也写进预算表，才不会在周期中段被突发账单打乱节奏。毕竟，财务可控，情绪才能稳定；情绪稳定，激素才会听话；激素听话，子宫才会迎来最好的那颗胚胎。

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