Complete Guide to the IVF Process: From Examination to Embryo Transfer

Introduction

For many families facing fertility challenges, in vitro fertilization (IVF) is not just a medical procedure but a journey filled with hope and challenges. According to 2023 data from China's National Health Commission, the number of assisted reproductive technology cycles in China has exceeded 1 million, with average clinical pregnancy rates ranging from 40% to 50% (depending on age and cause). However, many international patients are unfamiliar with the specific process and may feel anxious due to information asymmetry. This article uses a top-tier tertiary reproductive center in Shanghai, served by MeiJiaKang, as an example to break down every step from initial consultation to embryo transfer, so you can be well-informed and act with confidence.

Step 1: Preliminary Examinations and Evaluation (1-2 weeks)

IVF does not begin directly with ovarian stimulation; it requires a comprehensive medical evaluation first. Standard examinations include:

For women: Hormone panel (on days 2-3 of the menstrual cycle), AMH (anti-Müllerian hormone), transvaginal ultrasound (basal antral follicle count), thyroid function, and infectious disease screening (hepatitis B, syphilis, HIV, etc.).

For men: Semen analysis (requires 2-7 days of abstinence) and genetic screening (e.g., thalassemia, chromosomal karyotype).

For both partners: Blood type, coagulation function, and electrocardiogram (for older patients or those with chronic conditions).

If you are traveling to Shanghai from abroad, it is recommended to submit your previous medical reports in advance through MeiJiaKang's remote consultation, so doctors can assess whether additional tests are needed, avoiding waiting time upon arrival. Test results are typically available within one week, and the doctor will develop a personalized plan based on them.

Step 2: Ovarian Stimulation Protocol (10-14 days)

The goal of ovarian stimulation is to obtain multiple mature eggs, rather than the single egg in a natural cycle. Common protocols include:

Long protocol: Down-regulation for one week before starting stimulation, suitable for women with normal ovarian function.

Antagonist protocol: Direct stimulation with the addition of an antagonist later to prevent premature ovulation, suitable for women with polycystic ovaries or high ovarian response.

Mild stimulation protocol: Oral medications plus low-dose injections, suitable for women with poor ovarian response or advanced age.

During stimulation, blood tests and ultrasounds are required every 2-3 days to monitor hormone levels and follicle size. Shanghai centers typically use imported Gonal-F or domestic Lishenbao, costing approximately 8,000-15,000 RMB per cycle. The key point is: strictly follow the doctor's instructions for injections, avoid strenuous exercise, but complete bed rest is not necessary. Most patients reach the trigger criteria (HCG or GnRH-a) on days 10-12, with egg retrieval performed 36 hours later.

Step 3: Egg Retrieval and Sperm Collection (Completed in One Day)

Egg retrieval is a minimally invasive procedure performed under intravenous sedation, taking 15-30 minutes. The doctor uses a needle guided by transvaginal ultrasound to aspirate follicular fluid; with skilled practitioners, the success rate is high. After the procedure, patients are observed for 2 hours and can leave if no abnormalities are present. Common side effects such as mild bloating and slight vaginal bleeding typically resolve within 24 hours.

On the same day, the male partner provides a semen sample (after 3-5 days of abstinence). If the male has severe oligospermia or asthenospermia, testicular sperm extraction may be needed. The retrieved eggs and sperm are combined in the laboratory to form embryos. Note: After egg retrieval, oral antibiotics are required to prevent infection, and pelvic baths and sexual intercourse should be avoided for 2 weeks.

Step 4: Embryo Culture and Genetic Screening (3-6 days)

Fertilized eggs develop in an incubator, forming cleavage-stage embryos on day 3 and blastocysts on day 5. Blastocyst transfer has a higher success rate (approximately 50% vs. 30%). If you have a risk of genetic disorders or a history of recurrent miscarriage, PGT-A (preimplantation genetic testing for aneuploidy) may be considered, costing approximately 20,000-30,000 RMB, which can significantly reduce miscarriage rates.

Laboratory quality is crucial. Top-tier reproductive centers in Shanghai have time-lapse imaging systems that monitor embryo division in real time, avoiding frequent disturbances. The centers partnered with MeiJiaKang are all CAP-certified internationally, with stable embryo culture success rates (fertilization rates) above 90%.

Step 5: Embryo Transfer and Luteal Phase Support (12-14 days after transfer)

Transfer is performed on days 17-20 of the cycle, without anesthesia, similar to a gynecological exam. The doctor places 1-2 embryos into the uterine cavity using a soft, thin catheter; the entire procedure takes 5 minutes. After transfer, bed rest for 2 hours is recommended, but prolonged bed rest is not necessary—studies show that extended bed rest can reduce blood flow and hinder implantation.

After transfer, progesterone gel or injections are used until the pregnancy test day (blood HCG test 12-14 days after transfer). Key tips: Avoid strenuous exercise and heat therapy, maintain emotional stability, but normal work and daily activities are entirely feasible. If the pregnancy test is positive, luteal support is continued until weeks 8-10 of pregnancy.

Recommendations for International Patients

Plan your time: A complete cycle requires approximately 25-30 days of stay in Shanghai (including examinations). If PGT is needed, extend this to 40 days, as embryo biopsy results take 2 weeks to be reported.

Budget for costs: A routine cycle (including examinations, stimulation, egg retrieval, and transfer) costs approximately 30,000-50,000 RMB; PGT adds an additional 20,000-30,000 RMB. MeiJiaKang provides a cost estimation tool to help you budget accurately.

Choose a hospital: Ensure the reproductive center has National Health Commission qualifications and pay attention to laboratory success rates and annual cycle numbers. You can obtain written data on partner hospitals through contact us.

Mental preparation: The success rate per cycle is not 100%; it is approximately 50% for women under 35 and drops to around 20% for those over 40. It is advisable to reserve funds and leave time for 2 cycles.

Legal and logistical considerations: Chinese law permits legal assisted reproduction, but marriage certificates and ID are required. International patients need to have documents translated and notarized. MeiJiaKang can assist with medical visas and accommodation arrangements.

IVF is a combination of science and patience. The rigor of each step stems from respect for life. May you find less confusion and more confidence on this journey.