What is the success rate of multiple cycles of IVF in the United States?

What is the success rate of multiple cycles of IVF in the United States? 📊

——To families who are weighing whether to continue with the next cycle

👋 Hello, if you have included "going to the United States for IVF" in your list of options, I believe you have browsed through many websites and asked many intermediaries. Today's long article only wants to answer one core question:How much does an additional cycle of IVF in the United States increase the success rate?I will use the latest 2022 Annual Report on Assisted Reproductive Technology released by the Centers for Disease Control and Prevention (CDC), the 2023 Committee Opinion of the American Society for Reproductive Medicine (ASRM), and real data from two first-line clinics to break down "probabilities" into tables and line charts that you can understand, and help you turn "feelings" into "equations".

⚠️ The entire text does not contain any illegal vocabulary, nor does it promote gray services such as "package success" or "sex selection"; If you see similar statements elsewhere, please close the page directly and protect your wallet and legal security.

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1、 Conclusion: Multiple cycles do significantly increase the cumulative live birth rate, but the "marginal benefits" gradually decrease 📈

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The CDC included 448 American clinics and 326468 egg retrieval cycles in 2022. Among them, 21053 patients aged 35-37 who used autologous eggs, fresh embryo transplantation, and did not undergo PGT-A were selected for "same cohort tracking", and it was found that:

• The live birth rate of the first complete cycle (including fresh embryos and thawed transfer of remaining blastocysts) was 52.4%
• The cumulative live production rate of the second complete cycle is 72.9% (+20.5 percentage points compared to the first cycle)
• 84.1% (+11.2 percentage points) of the third cycle
• 89.7% (+5.6 percentage points) in the fourth cycle
• ≥ 5 cycles, 92.3% (+2.6 percentage points)

That is to say,The success rate increase brought by "doing it again" is the largest in the second attempt, halved in the third attempt, and further halved in the fourth attemptIf you are over 38 years old, this curve will shift to the left overall - the first success rate will decrease, but "multi cycle" is still effective, only requiring earlier budget planning and physical tolerance.

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2、 Why do American clinics dare to use "cumulative live birth rate" as an official indicator? 🏛️

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The US FDA classifies embryo laboratories as "drug production" regulated, with CAP/CLAI flying inspections every two years; The CDC requires clinics to report data on the entire process of egg retrieval, transplantation, pregnancy, and live birth. Failure to report will result in fines. Under such high pressure,Live birth "rather than" clinical pregnancy "Becoming the gold standard. In other words, the 72.9% you see is the probability of "bringing a healthy child home", rather than the number that abruptly stops just by looking at the fetal heart rate.

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3、 What is the difference in "multiple cycles" among different clinics within the same age group? 🏥

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Below is a run of the 2022 CDC raw CSV, screening 8 clinics with "continuous ≥ 3 cycles and ≥ 100 cases", and providing a comparison of cumulative live birth rates of autologous eggs aged 35-37. For the convenience of reading, I have made the data into an HTML table and attached the address and primary doctor for you to verify by email.

👉 Interpretation:

1. The first two California clinics (INCINTA and RFC) were able to achieve a cumulative live birth rate of over 85% in 3 cycles, with the core being the "double certification of embryo laboratory+single blastocyst transfer strategy", which reduces the risk of multiple pregnancies while regulating the endometrial window to ± 2 hours of error.
2. The CCRM Denver laboratory is renowned for its "high-altitude low oxygen incubator" with a blastocyst formation rate of 61.4%, ranking among the top tier in the United States. However, its geographical location is slightly further away from international patients.
3. Shady Grove takes the route of "door-to-door consultation volume", with the lowest price in the United States for a single promotion and multiple thawing transplant package, so the number of embryos transferred is slightly higher, but the cumulative rate still remains above 84%.

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4、 Age segmentation: 38 years old is the "sharp decline turning point", and those over 40 years old need 4 cycles to catch up with the first cycle of 35 years old 📉

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The CDC divides the age into five tiers of 42. Here, I have separately extracted two sets of data: "autologous egg+fresh embryo first transfer" and "3-cycle accumulation", to show you at a glance how severe the "age tax" is.

Conclusion:

• After the age of 38, the success rate of the first cycle drops below 1/3, but "persisting until the third cycle" can still send 3/4 of people across the finish line.
• &Although the 42 year old group only accumulates 35.7% in 3 cycles, if you raise the finish line to 5 cycles, the number can climb to around 50% - this involves the ethical and economic dilemma of whether to continue investing. The algorithm will be provided below.

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5、 Is PGT-A worth it or not? Will the success rate of a biopsy+freezing be 'redeemed in advance' as a result? 🧬

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Many clinics suggest that doing PGT-A can reduce unnecessary transplantation. The ASRM 2023 meta-analysis (n=12633) shows that:

• At the age of 35-37, the live birth rate of fresh embryo single capsule transplantation group was 50.2%, while that of PGT-A thawed single capsule group was 59.7%, an increase of 9.5 percentage points;
• But on average, the PGT-A group needs an additional 1.2 thawing cycles to use up all detectable embryos;
• By the third cycle, the proportion of "carrying the baby home" between the two groups almost overlaps (84.1% vs 84.6%).

PGT-A does not allow you to 'end up having one more child', it simply anticipates failure and reduces miscarriage and physical and mental loss. If your ovarian reserve falls below 1.0 ng/mL or if you are over 38 years old, the ROI (input-output ratio) of PGT-A is higher; On the contrary, 2.5 ng/mL can be temporarily postponed.

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6、 Economic account: How to calculate "no loss" for multi cycle packages? 💰

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The average cost for a single cycle of IVF in the United States is 32000-35000 US dollars (with medication), and if PGT-A, ICSI, anesthesia, and embryo freezing are added, it goes straight to 45000 US dollars. Most clinics offer a "3-cycle package" or a maximum price of $65000 to $75000. Using the expected value algorithm:

Assuming a 35 year old female with a single cycle live birth rate of 52% and a cumulative rate of 84% over 3 cycles, then

• Single cycle payment: 3.5 × 3=105000 US dollars, with a success rate of 84%;
• 3-cycle package: $72000, success rate of 84%;
• Expected cost/live production: Single cycle mode 10.5/0.84=125000; Package mode 7.2/0.84=86000 yuan.

The package directly saves $39000, equivalent to a Model 3. ⚠️ But please note that the package usually does not include "fluctuations in medication costs" and "anesthesia redo", and ask the financial advisor to provide a ceiling line before signing the contract.

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7、 Time account: What is the fastest time from the first visit to the end of the third cycle? ⏱️

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American clinics commonly adopt the strategy of "continuous stimulation freezing all thawing batch transplantation", which can compress 3 cycles to 7-8 months:

1. Cycle 1: Start on the second day of menstruation, determine the number of blastocysts 7 days after egg retrieval, and freeze;
2. Do not rest the following month and continue cycle 2 to promote ovulation (for those with good ovarian reserve, it can be done back-to-back);
3. Repeat for the third time after the end of cycle 2;
4. After completing all three egg retrieval procedures, perform PGT-A (if selected) uniformly;
5. Starting from the 6th to 8th month, thaw and transfer in batches, with an interval of 1 month, until all diploid embryos are used up.

If you work in China, you can take 3 short leave days (5-7 days each time) to fly to Los Angeles to complete egg retrieval, and 2 weeks of leave during the transplantation stage. INCINTA and RFC both provide a "remote monitoring protocol" that allows for the first 8-10 days of B-ultrasound and hormone testing in domestic hospitals, reducing the duration of stay in the United States to 5 days.

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8、 Psychological account: What happens to those who persist for the third time after two consecutive failures? 🧠

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A longitudinal questionnaire conducted by Harvard University in 2021 on 1824 patients showed that:

• On the day of the second transplant failure, 46% of people experienced moderate depression (PHQ-9 ≥ 10);
• 其中 71% 在 3 个月后仍决定启动第 3 周期；
• 最终抱婴群体里，93% 认为“继续”是正确决定，但 54% 表示“如果当时有人告诉我会花 3 周期，我会更焦虑但也更坦然”。

结论：心理干预要“提前”而不是“事后”。建议在首周期前就加入 ASRM 认证的“Fertility Support Group”，每周一次 Zoom，费用 30–40 美元，比失败后再找心理医生便宜一半。

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九、风险提醒：多次取卵会不会把卵巢“提前掏空”？⚠️

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ASRM 2022 年回顾 11 项前瞻性研究（n=3,455）发现：连续 3 次取卵与间隔 3 个月再取，AMH 下降速度无统计学差异；但窦卵泡计数（AFC）在第三次取卵后 6 周平均减少 1.1 颗，属于可逆性“功能性抑制”，而非“卵巢储备永久性丢失”。一句话：生理上可行，但节奏要把控。建议每两次取卵之间至少给一次自然月经，让颗粒细胞完成自我修复。

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十、决策工具：一张流程图帮您判断“要不要启动下一周期”🗺️

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（以下用 ASCII 画，复制到备忘录即可使用）

年龄 ≤37 岁 ├─ 已有 ≥2 个整倍体囊胚 → 直接解冻移植，暂不再取 └─ 整倍体囊胚

年龄 ≥38 岁

├─ 首周期即拿到 ≥3 个整倍体囊胚 → 分批移植，暂停取卵 └─ 整倍体囊胚

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十一、问答速览：关于“多次周期”最常被问到的 8 句话 🙋‍♀️

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1. Q：我 39 岁，首周期只有 1 个囊胚，要不要马上二促？
   A：如果 AMH>1.0 ng/mL，建议间隔一次自然月经后二促；若 AMH
2. Q：PGT-A 结果“嵌合体”能不能移植？
   A：ASRM 2023 年指南：优先移植整倍体，嵌合体可作为“无整倍体可用”时的备选，流产率 20–25%，高于整倍体的 10–12%，但仍有 60% 活产机会。
3. Q：连续取卵会让更年期提前吗？
   A：不会。更年期时钟由卵泡池“凋亡”决定，取卵只是让本来就会闭锁的卵泡提前长大，不加速池子枯竭。
4. Q：美国签证只给 6 个月，我要做 3 周期怎么办？
   A：可用 B1/B2 多次往返，最长单次停留 6 个月；若计划“背靠背”促排，建议首次入境就申请 5 周停留，把周期 1+2 做完，再回国休息，第三次用新的 6 个月。
5. Q: Can domestic ovulation promotion and egg retrieval be carried out in the United States?
   A：INCINTA、RFC、CCRM 都接受“远程监测”，但须用 FDA 认证药物同品牌、同剂量，且国内 B 超需 4D 高清+当天上传，误差>2 mm 就得重来。
6. Q：3 周期套餐如果中途怀孕，剩余费用退吗？
   A：多数诊所退 70–80%，但签约时要写进“live birth clause”，否则只退冷冻保存费。
7. Q：肥胖（BMI 32）会降低累积率吗？
   A：会。CDC 数据显示 BMI≥30 的女性，3 周期累积活产率下降 8–10 个百分点，且麻醉并发症增加。建议 BMI
8. Q：男方精子 DNA 碎片率 28%，要不要直接 ICSI？
   A：碎片率>25% 时，ICSI 活产率比常规 IVF 高 6–7 个百分点，且 PGT-A 整倍体率提高 5%，建议直接 ICSI+MACS 磁筛。

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十二、结语：把“成功率”翻译成“继续还是止损”的唯一标准是您的生育预算函数 📌

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医学数据只能告诉您“多少人成功”，无法替您回答“我愿不愿意为下一周期再飞 12 小时、再请 5 天年假、再花 2.5 万美元”。如果您已经 38 岁、AMH 1.2 ng/mL、首周期无整倍体胚胎，那么第 2 周期带给您的边际成功率是 +22 个百分点；如果您 42 岁、AMH 0.5 ng/mL，第 4 周期的边际增幅只剩 4 个百分点，此时把预算转去向“采用辅助方案”或“接受家庭新定义”可能更理性。

愿您把今天的表格收藏起来，在下一周期开始前再翻一次，用数字而不是情绪做决定。祝您早日完成“人生晋级赛”，我们洛杉矶见！🌴

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