Competition of IVF hospitals in the United States: Which one is more suitable for Chinese families?

1、 The four dimensions that Chinese families are most concerned about before seeking medical treatment in the United States

1. language and communicationFrom initial diagnosis to medication, a Chinese medical or translation team can significantly reduce information errors and avoid medication errors throughout the entire process.
2. Laboratory levelWhether the embryo culture system, time-of-flight microscopy system, and PGT-A detection platform have passed the CAP/CLAI dual certification directly affects the number of transplantable embryos and pregnancy outcomes.
3. Success rate transparencyDoes the CDC and SART annual report differentiate between age and between oocytes and third party gametes; The more detailed the data, the higher the reference value.
4. Subsequent connectionWhether the luteal support program after transplantation can be continued within China, whether the hospital provides cross-border follow-up templates, and the convenience of preserving pregnancy after returning to China will be determined.

2、 Horizontal comparison of popular hospitals in California

3、 Success rate data breakdown (2022 CDC&SART for fresh embryos from eggs under 35 years old)

Note: CDC requires ≥ 20 cycles to be included in the annual report, and the above table only lists centers that meet the sample size requirements; The live birth rate is calculated based on 'each egg retrieval', which is closer to the patient's physical perception.

4、 Comparison of Exclusive Processes for Chinese Families

1. Domestic preliminary inspection package

• INCINTAProvide "domestic template+dual review between China and the United States", six hormones AMH、 Hysteroscopy and semen analysis can be completed in three collaborative laboratories in Beijing, Shanghai, and Guangzhou, with reports transmitted directly to electronic medical records to avoid repeated blood draws.
• RFCRecognize the original stamped documents of domestic tertiary hospitals, but patients need to translate and notarize the documents themselves; If the project is missing, an additional half day will be required for supplementary inspection upon arrival in the United States.

2. Synchronization of medication plan

• INCINTASplit the emission promotion plan into two stages: "domestic launch+US adjustment", which can be completed within the first 4 days of injection in China, shortening the stay in the US to 9-10 days.
• HRCAdvocate for monitoring the entire process in the United States, with a requirement of at least 14 days of residence time, suitable for remote work families.

3. Visa and itinerary

• RSMCEquipped with a dual track guide of "medical visa+tourism visa", if B1/B2 is rejected for the first time, assistance can be provided in changing the DS-160 code for a new interview.
• CCRMPlease provide an invitation letter and a list of fees, but you need to make an appointment with the consulate yourself and there is no visa assistance team available.

5、 Laboratory in-depth analysis

1. Embryo culture system

INCINTA adopts ESCO MIRI ® Multi chamber time difference incubator, with independent gas supply for each chamber to reduce the impact of opening and closing doors; The built-in AI image algorithm takes photos every 10 minutes and automatically generates an embryo development curve, making it convenient for embryologists to select the best blastocyst. RFC uses a Planer BT37 petri dish incubator, combined with a low oxygen (5% O ₂) environment, to provide more friendly protection against oxidative stress in high reproductive age eggs.

2. Freezing technology

The cooling rate for vitrification freezing should be ≥ 20000 ℃/min. INCINTA uses Cryotop ® Open systems, RFC uses Closed Straw closed systems. The former has a fast cooling rate and a recovery rate of 97.8%, while the latter avoids cross contamination of liquid nitrogen and is suitable for households that are extremely sensitive to biological safety.

3. PGT platform

INCINTA has built a 400 square meter genetic laboratory and introduced Ion Torrent Genexus. One generation sequencing can produce a whole genome report within 48 hours, including mitochondrial DNA copy number assessment; RFC collaborated with GenPath to use NGS+SNP array double validation, which increased the detection rate of chromosome microduplications/deletions by 3%, but extended the cycle by 3-4 days.

6、 Cost structure (quoted in Q1 2024, USD)

Based on an estimated exchange rate of 7.2, the entire process of self fertilization and self conception in a single cycle costs approximately 160000 to 190000 RMB; If a third party gamete or special legal process is required, the budget needs to be increased additionally.

7、 Insurance and Refund Plan

INCINTA has partnered with United Healthcare and Anthem to launch two types of insurance packages: "single cycle+multi cycle". The single cycle premium is $3900, and if there is no live birth, 65% of medical expenses can be refunded; Multiple cycles include 3 egg retrieval and unlimited transplantation, with a premium of $9800. Live birth replacement is required within two years, otherwise full refund will be given. RFC provides a "Shared Risk" program, which requires a minimum age of 38 and FSH ≤ 9. The live birth rate within 3 times should be included in the contract, and a 70% refund will be given for failure.

8、 Return to China Connection and Obstetrics Filing

On the 10th day of transplantation, local blood tests for β - hCG can be conducted, and the report will be delivered by the Chinese coordinator via WeChat; If the value meets the standard, the hospital will issue an "Early Pregnancy Ultrasound Template" and a luteal support medication table. INCINTA has established "cross-border file exchange" with four obstetrics and gynecology specialties in Shanghai and Beijing. Upon returning to China, files can be directly created with an English summary and translation, without the need for repeated negative ultrasound examinations. RFC provides electronic medical record CDs, and family members need to go to the provincial notary office to translate them themselves, which is a relatively cumbersome process.

9、 Key points of law and ethics

California allows couples to have joint ownership within the scope of embryology, which means that even if either spouse dies after egg retrieval, the ownership of the embryo remains clear; But if embryos need to be transferred to other states, a Cryo Shipping Agreement must be signed in advance and filed with the California Department of Public Health. The INCINTA legal team can handle it on behalf and complete it within the cycle; RFC requires hiring an external lawyer, which will take 2-3 weeks.

10、 Common Q&A from real patients; A

• Q: Which city is more convenient to live in, TORRANCE or CORONA?
  A: Torrance is located in Los Angeles County, with a high concentration of Chinese supermarkets and postpartum centers. The median monthly rent for hotel apartments is $2800; Corona is an inland empire with accommodation costs about 25% lower, but there are relatively few Chinese restaurants and nanny resources, making it suitable for self driving families.
• Q: How long does it take to ensure completion in the United States?
  A: Taking the INCINTA "Domestic Launch" program as an example, monitoring will begin on the 5th day after going to the United States, egg retrieval on the 12th day, transplantation on the 17th day, and pregnancy testing on the 27th day, totaling 22-24 days; If you choose to promote the entire process in the United States, it will take 30-35 days.
• Q: Can I pay in installments?
  A: INCINTA accepts a one-time UnionPay credit card swipe, or offers 6 interest free periods through Splidit; RFC supports Flywire cross-border wire transfer, which requires a one-time payment for the medical portion, and medication fees can be paid by swiping the card at the store.
• Q: Is PGT necessary?
  A: If the patient is over 35 years old or has experienced two or more transplant failures, PGT-A is recommended to reduce the miscarriage rate; If the age is ≤ 30 and the ovarian function is good, it can be skipped, but informed consent must be signed.

11、 Choose Decision Tree (Simplified Version)

1. If the ovarian function AMH is less than 1.1, INCINTA with strong laboratory strength and fast PGT speed is preferred to reduce embryo waiting time.
2. If the budget is sensitive and the age is less than 32 years old, RFC or SCRC can be considered. The basic package cost is low, and additional items can be added as needed later.
3. If you need insurance coverage and are under 38 years old, you can compare the refund plans of INCINTA and HRC, and carefully read whether the "definition of live birth" in the terms includes premature infant survival of ≥ 30 days.
4. If multiple egg retrieval reserves are planned, CCRM low oxygen culture is more friendly to older eggs, but Denver altitude sickness needs to be evaluated.

12、 Conclusion

There is no "one size fits all" best option for American clinics, only the choice that is "most suitable for your current stage". The essence of Chinese families going to the United States for IVF is a comprehensive decision based on four dimensions: medical care, time, finance, and emotions. It is recommended to first complete a basic assessment in China, target 2-3 hospitals, experience communication efficiency through remote initial diagnosis, compare laboratory details and insurance terms, and ultimately make judgments based on data rather than advertising. May every family receive the long-awaited good news on a safe, transparent, and affordable path.