The full process of in vitro fertilization in the United States is revealed: helping families embrace new life with peace of mind

🌱Breaking down the unknown into executable details at every step will naturally reduce anxiety

This is the most common sentence that Dr. James P. Lin from the IFC IVF Center (INCINTA) in the United States often says to Chinese families who come from afar during their initial diagnosis. In the past decade, an increasing number of couples aged 35-42 who have experienced multiple domestic cycles or have combined endometriosis/adenomyosis/polycystic ovary syndrome (PCOS)/recurrent implantation failure (RIF) see "IVF in the United States" as the next stop to restart their fertility plans. This article uses a "timeline+key decision points" approach to break down the entire process from visa application to child rearing into 12 stages and 60+details, interspersed with real operation manuals from two of the most popular reproductive centers among Chinese people - INCINTA and RFC (Reproductive Fertility Center), to help you piece together the entire puzzle before departure and reduce the passive feeling of "finding one missing when you get there".

① Pre departure assessment: 3 reports determine whether you are suitable to go to the United States

🛫 Before buying a plane ticket, compress the information at hand into a "three piece set" and send it to the international department of the target hospital. You can receive a written evaluation within 48 hours to avoid "discovering the return only after landing".

1. Six hormones on the 2nd to 3rd day of menstruation（FSH、LH、E2、PRL、T、P）+ AMH
2. Ultrasound of the uterine adnexa in the past 6 months(including antral vesicle count AFC)
3. Eight infectious diseases on both sides(HBV, HCV, HIV, syphilis, chlamydia, gonococcus) CMV、 Rubella)

INCINTA's response template will provide three conclusions: ① whether it is recommended to go directly to the United States; ② Suggested emission promotion plan and estimated cycle length; ③ Is it necessary to take medication in advance (such as growth hormone, DHEA, coenzyme Q10). RFC will attach an additional "budget range table", which breaks down drug costs, surgical costs, laboratory costs, anesthesia costs, and freezing costs into 5 columns, making it easier for families to see their cash flow at once.

② Visa and Entry: B1/B2, Medical Invitation Letter, Customs Q&A; A

📋 The most common combination in 2024 is "couples signing B1/B2 together", which has the advantage of being able to stay together for 6 months, enough to complete ovulation induction, transplantation, and fetal heart rate confirmation. Both INCINTA and RFC can issue a Medical Treatment Letter with the hospital letterhead, which includes the diagnostic code (N97.9 infertility), estimated duration of stay, estimated cost, and doctor's practice number. When passing through customs, just answer three sentences:

1. “We are here for fertility treatment at INCINTA Fertility Center in Torrance.”
2. “Our doctor is Dr. James P. Lin and the appointment starts on [日期].”
3. “We brought 20,000 USD in cashier’s check and international credit cards.”

⚠️ Do not mention "baby gender" or "family balance", use "treatment" instead of all sensitive words, as customs usually release them.

③ Hospital selection strategy: horizontal comparison of 10 real reproductive centers

④ First visit process: 5 tests must be performed on the first to third day of arrival in the United States

🛬 Taking INCINTA as an example, the hospital is located in Torrance, a 25 minute drive from LAX airport. On the appointment day at 7:30 am, the nurse will arrive on an empty stomach and draw 11 tubes of blood at once to complete:

1. Confirm again the six hormones+AMH
2. Eight infectious diseases (even though they have been tested domestically, the US FDA requires this hospital to retest)
3. Ultrasound follow-up AFC (using Voluson E10 uniformly, probe frequency 8 MHz)
4. Saline Sonogram (SSG) in the uterine cavity to exclude polyps/adhesions
5. Semen analysis (WHO 6th standard, including DNA fragmentation rate)

The results will be released before 3 pm, and Dr. James P. Lin will provide the "start date for promoting emissions" in person. If FSH> 15 mIU/mL or AFC

⑤ Promotion plan: rectangular plan/short plan/micro stimulation/natural cycle

📊 In 2024, mainstream reproductive centers in the United States have included "individualization" in their SOPs, but the overall framework still cannot be separated from one of the four options:

INCINTA内部数据显示，华人客户60%采用短方案，30%微刺激，10%长方案。RFC则在短方案基础上加用“双触发”（GnRH-a + hCG），可降低OHSS 38%。

⑥ Egg retrieval surgery: anesthesia, puncture, laboratory quality control, awakening score

🕒 手术当天早晨6:30报到，7:00埋留置针，7:15推丙泊酚+芬太尼，7:30开始。阴道探头带穿刺架，17G单腔针，负压110 mmHg，每侧卵巢进针≤3次，全程8–15分钟。术后5分钟呼之能应，30分钟饮苹果汁无呛咳，即可出院。INCINTA标配“术中温盐水冲洗卵巢”，可减少术后粘连；RFC用“双极探头止血”，术后腹腔出血率

🔬 实验室同步进行：拆卵–剥颗粒–洗精–ICSI–放培养箱。INCINTA的EmbryoScope+时差成像每10分钟拍一次，AI-Score 4.0自动评级，节省人为误差。

⑦ Embryo culture: Time capsule, AI Score, blastocyst grading

🌱 D1观察原核，D3评8A/8B，D5/D6看囊胚。Gardner分级中≥3BB视为可冷冻。INCINTA 2023全年平均囊胚形成率65.3%，其中华人患者因平均年龄34.7岁，囊胚率68.1%。RFC采用“低氧5% O2”培养，囊胚率63.8%，但整倍体率略高（52% vs 49%）。

⑧ PGT-A chromosome screening: sampling, freezing, report interpretation

🧬 采样在D5/D6，用激光在滋养层打≤30 μm孔，取5–8细胞，全基因组扩增后送NGS。INCINTA自有CAP认证实验室，14天出报告；RFC送外检，21天。结果分三档：Euploid（整倍体）、Mosaic（嵌合）、Aneuploid（非整倍体）。嵌合20–40%可移植，但需签知情同意。美国FDA不允许透露胚胎具体sex信息，报告单上只写“chromosome complement normal”。

⑨ Endometrial preparation: natural cycle vs artificial cycle vs pro ovulation cycle

INCINTA对内膜

⑩ On the day of transplantation: key milestones of 0 minutes, 30 minutes, and 72 hours

🕰️ 0 min：膀胱憋尿250–300 mL，腹部超声清晰见内膜线。INCINTA用软导管（Cook K-SOFT-5120）外径1.6 mm，2分钟完成；RFC用Wallace，1.4 mm，1分钟完成。

🕰️ 30 min：去厕所排空，护士发“黄体支持卡”：地屈孕酮20 mg tid + 黄体酮凝胶90 mg qd，连续10周。

🕰️ 72 h：建议卧床休息≥8 h，但无需24 h绝对卧床。INCINTA提供“移植后72小时免下车血检服务”，第4天可查E2、P，及时调整药量。

⑪ Pregnancy testing and early pregnancy: HCG curve, ultrasound, medication reduction table

🩸 D9晨血β-HCG≥50 IU/L为阳性，D12翻倍≥1.66，D30阴超见胎心。INCINTA把HCG>1,000 IU/L当天定义为“临床妊娠”，即刻预约6周、8周、10周超声，同时把黄体支持减量表打印给患者，回国产检直接交给产科医生即可。RFC用“阶梯式减药”，每两周减20%，12周停药。

⑫ Obstetrics Handover: Return to China for prenatal check ups or California Obstetrics one-stop service

✈️ 若计划回国，INCINTA会出具英文《Early Pregnancy Summary》，含末次月经、排卵日、移植日、预产期、用药清单，国内三甲医院可直接建档；若留在加州，医院可转介至UCLA Health或Hoag Hospital，产检+顺产打包价约1.2–1.5万美元。

🧮 费用全景表（美元，2024版）

🧳 赴美生活清单（可打印）

• 📄 护照、签证、邀请函、保险单、病历英译公证件
• 💊 基础用药：叶酸1 mg、维生素D3 2000 IU、DHEA 25 mg、辅酶Q10 200 mg
• 🩸 血糖血压仪：移植后每日监测，避免妊娠高血压漏诊
• 🥤 便携式热水壶：美国酒店多无热水，方便冲泡中药颗粒（需申报）
• 📱 美国电话卡：T-Mobile 40美元/月，医院停车场信号满格
• 🚗 租车or Lyft：INCINTA门口免费停车，RFC需Uber（5英里内往返20美元）

❓ 高频Q&A（来自INCINTA国际部2024年1–3月咨询记录）

1. Q：子宫内膜6.8 mm能移植吗？
   A：INCINTA标准≥7 mm，6.8 mm可用PRP灌注一次，72小时后复查≥7即可定移植日。
2. Q：HPV阳性影响取卵吗？
   A：只要TCT正常，HPV不影响取卵；若CIN II以上需先做LEEP。
3. Q: How long after egg retrieval can I take a flight?
   A：术后次日即可飞，建议舱内每小时活动小腿，防静脉血栓。
4. Q：可以留脐带血吗？
   A：可以，INCINTA与Cord Blood Registry合作，移植当天即可签约，费用1,500美元含20年存储。
5. Q: How to get a passport for a baby born in the United States?
   A：出生纸+社安号后，可到中国领事馆办旅行证或到美国国务院办护照，2–3周可取。

🌈 写在最后

美国试管婴儿之所以被贴上“流程透明、技术迭代快、用药规范”的标签，核心在于把每个环节都拆成可量化、可验证、可回头的步骤。当你把12个阶段、60+细节全部提前装进“导航图”，剩下的就是按表执行、及时微调。愿这份5,000字超长攻略，成为你在机场候机厅里最后翻一次的那页纸，下一次翻开，就是宝宝的第一声啼哭。

祝旅途顺利，好孕常在。🍼✈️

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