How is IVF at the First Maternity and Infant Health Hospital Affiliated with Tongji University Shanghai? Analysis of Technology, Process, and Costs
The Reproductive Center of the First Maternity and Infant Health Hospital Affiliated with Tongji University (Shanghai First Maternity and Infant Hospital) is one of the earliest public tertiary hospitals in Shanghai to carry out assisted reproductive technology, with qualifications for first, second, and third-generation IVF. This article provides an objective reference from the perspectives of hospital strength, IVF process, cost composition, and applicable population.
Direct Answer: Overall Situation of IVF at the First Maternity and Infant Hospital
The Reproductive Center of the First Maternity and Infant Health Hospital Affiliated with Tongji University (referred to as "Shanghai First Maternity and Infant Hospital") is one of the medical institutions approved by the Shanghai Municipal Health Commission to carry out assisted reproductive technology. It offers services including artificial insemination by husband (AIH), conventional in vitro fertilization-embryo transfer (IVF-ET, i.e., first-generation IVF), intracytoplasmic sperm injection (ICSI, i.e., second-generation IVF), and preimplantation genetic testing (PGT, i.e., third-generation IVF). The center has accumulated considerable clinical experience in infertility diagnosis and treatment, reproductive endocrine regulation, and genetic disease screening.
From a clinical data perspective, the clinical pregnancy rate of IVF at the First Maternity and Infant Hospital Reproductive Center is at the upper-middle level among domestic public hospitals, but specific data vary individually due to factors such as female age, cause of infertility, and ovarian reserve function. The following content will elaborate from the perspectives of process, cost, applicable population, and key indicators.
Hospital Background and Reproductive Center Qualifications
Shanghai First Maternity and Infant Hospital was established in 1947. It is a tertiary A-level specialized obstetrics and gynecology hospital in Shanghai and a teaching hospital affiliated with Tongji University. Its Reproductive Center is one of the key departments of the hospital, with an independent embryology laboratory and genetic testing platform.
Technical Projects Available at the Center
| Technology Type | Applicable Conditions |
|---|---|
| Artificial Insemination by Husband (AIH) | Mild male oligoasthenospermia, cervical factor infertility, unexplained infertility |
| First-generation IVF (IVF-ET) | Female tubal factor, ovulation disorders, endometriosis, etc. |
| Second-generation IVF (ICSI) | Severe male oligoasthenospermia, obstructive azoospermia, previous fertilization failure |
| Third-generation IVF (PGT) | Monogenic diseases, chromosomal structural abnormalities, recurrent miscarriage, advanced maternal age |
IVF Applicable Conditions and Population Differences
Situations by Age Group
Ovarian reserve function declines with age, which is a core variable affecting the success rate of IVF.
- Under 35 years old: Better ovarian response, relatively ideal number of oocytes retrieved, higher clinical pregnancy rate. The main issues in this age group are usually related to tubal factors or male factors.
- 35-38 years old: Ovarian reserve begins to show physiological decline. AMH levels and antral follicle count (AFC) may be lower than those under 35. Doctors adjust the ovulation induction protocol based on indicators such as AMH and FSH.
- 39-42 years old: Ovarian reserve is significantly decreased, the number of oocytes retrieved is reduced, and the rate of embryonic aneuploidy increases. Third-generation IVF (PGT-A) has greater application value in this age group for screening chromosomally normal embryos for transfer.
- Over 42 years old: Ovarian reserve is extremely low. Some individuals may not be able to obtain a sufficient number of oocytes for in vitro fertilization. Doctors will comprehensively evaluate ovarian function, hormone levels, male factors, etc., to formulate an individualized plan.
Suitable Population
- Bilateral tubal blockage or post-salpingectomy
- Moderate to severe endometriosis complicated with infertility
- Ovulation disorders with no pregnancy after ovulation induction treatment
- Male oligoasthenospermia, teratozoospermia
- Unexplained infertility with no pregnancy after other treatments
- Need for genetic disease prevention (third-generation IVF)
- Recurrent miscarriage requiring embryonic genetic testing
Unsuitable Population
- Uncontrolled severe internal or surgical diseases (e.g., uncontrolled hypertension, diabetes, thyroid diseases, etc.)
- Concurrent malignant tumors of the reproductive system
- Severe mental or psychological disorders preventing cooperation with treatment
- Unaddressed bad habits such as drug abuse or alcoholism
- Uncorrected uterine anatomical abnormalities (e.g., large uterine fibroids, intrauterine adhesions, etc.)
Standard IVF Process
A complete IVF cycle usually takes 2-3 months and is divided into the following stages:
Stage 1: Pre-treatment Examination
Female examination items: Sex hormone panel (FSH, LH, E2, etc.), AMH, thyroid function, infectious disease screening, chromosome karyotype analysis, hysteroscopy (if necessary), breast ultrasound, etc.
Male examination items: Semen routine analysis, sperm morphology analysis, infectious disease screening, chromosome karyotype analysis (if necessary), Y chromosome microdeletion testing (if necessary).
Stage 2: Ovarian Stimulation
The doctor selects an ovarian stimulation protocol based on the woman's age, AMH, FSH, antral follicle count, and other indicators. Common protocols include the antagonist protocol, long protocol, short protocol, and mild stimulation protocol. The stimulation cycle generally lasts 10-14 days, during which follicle development and hormone levels are regularly monitored.
Stage 3: Oocyte Retrieval and Sperm Collection
After follicles mature, human chorionic gonadotropin (hCG) or a GnRH agonist is injected to trigger ovulation. Oocyte retrieval is performed under vaginal ultrasound guidance 34-36 hours later. The procedure is usually performed under intravenous anesthesia and takes about 15-20 minutes. On the same day, the male partner provides a semen sample.
Stage 4: In Vitro Fertilization and Embryo Culture
In vitro fertilization is performed 4-6 hours after oocyte retrieval. Conventional IVF or ICSI is chosen based on semen quality. After fertilization, embryos are cultured until day 3 (cleavage stage) or day 5-6 (blastocyst stage). If third-generation IVF is required, trophectoderm biopsy is performed at the blastocyst stage for genetic testing.
Stage 5: Embryo Transfer
The timing of transfer is determined based on embryo quality and quantity, uterine environment, hormone levels, and other factors. The transfer procedure is performed under abdominal ultrasound guidance, takes about 5-10 minutes, and requires no anesthesia.
Stage 6: Luteal Phase Support and Pregnancy Test
After transfer, progesterone preparations are used for luteal phase support to maintain endometrial receptivity. A blood test for β-hCG is performed 12-14 days after transfer to determine if pregnancy has occurred.
Cost Composition and Influencing Factors
The total cost of IVF varies significantly depending on individual circumstances, medication protocols, technology type, and other factors.
Main Cost Items
| Item | Cost Range | Notes |
|---|---|---|
| Pre-treatment Examination | 3,000 - 6,000 RMB | For both partners; some tests have a validity period |
| Ovarian Stimulation Medications | 8,000 - 20,000 RMB | Significant price difference between domestic and imported medications |
| Oocyte Retrieval Surgery | 5,000 - 8,000 RMB | Includes anesthesia costs |
| In Vitro Fertilization and Embryo Culture | 8,000 - 15,000 RMB | Costs differ between first and second-generation IVF |
| Embryo Transfer | 3,000 - 5,000 RMB | Includes transfer catheter cost |
| Additional Cost for Third-generation IVF | 20,000 - 40,000 RMB | Includes embryo biopsy and genetic testing |
| Embryo Freezing and Storage | 2,000 - 3,000 RMB/year | Charged annually |
Main Factors Affecting Cost
- Ovarian Stimulation Protocol: Imported medications cost more than domestic ones; long protocols require higher medication doses than short or antagonist protocols.
- Technology Type: Second-generation IVF (ICSI) adds 3,000 - 5,000 RMB compared to first-generation; third-generation IVF (PGT) adds over 20,000 RMB.
- Response to Medication: Individuals with poor ovarian response may require increased medication doses or changes in medication type.
- Number of Transfers: Multiple transfers from a single oocyte retrieval can spread the cost of the retrieval surgery.
Interpretation of Key Examination Indicators
AMH (Anti-Müllerian Hormone)
AMH reflects ovarian reserve and can be tested at any time as it is not affected by the menstrual cycle.
- AMH > 2.0 ng/mL: Normal ovarian reserve
- AMH 1.0 - 2.0 ng/mL: Mildly decreased ovarian reserve
- AMH 0.5 - 1.0 ng/mL: Significantly decreased ovarian reserve
- AMH < 0.5 ng/mL: Severely decreased ovarian reserve
FSH (Follicle-Stimulating Hormone)
Basal FSH is measured on days 2-4 of the menstrual cycle and reflects ovarian function.
- FSH < 8 IU/L: Normal ovarian function
- FSH 8 - 12 IU/L: Mildly decreased ovarian function
- FSH > 12 IU/L: Significantly decreased ovarian function
Antral Follicle Count (AFC)
Antral follicles (2-9 mm in diameter) in both ovaries are counted via transvaginal ultrasound on days 2-4 of the menstrual cycle.
- AFC > 12: Normal ovarian reserve
- AFC 6 - 12: Mildly decreased ovarian reserve
- AFC < 6: Significantly decreased ovarian reserve
Frequently Asked Questions
Q1: How long is the waiting time for IVF at the First Maternity and Infant Hospital?
After the initial visit, completing the pre-treatment examinations for both partners takes about 1-2 months. Once all results are available, the doctor will schedule the start of the treatment cycle based on the woman's menstrual cycle, typically with a wait of 1-3 months.
Q2: Can IVF at the First Maternity and Infant Hospital be covered by medical insurance?
Currently, Shanghai has included some assisted reproductive technology items in the medical insurance coverage (subject to specific insurance policies), but most items are still self-paid. It is recommended to consult the hospital's medical insurance office for the latest policies during your visit.
Q3: Can we choose the sex of the embryo for IVF at the First Maternity and Infant Hospital?
According to the regulations of the National Health Commission, non-medical sex selection of embryos is prohibited. Third-generation IVF (PGT) is only used to screen for genetic diseases or chromosomal abnormalities and cannot be used for sex selection.
Q4: How many IVF cycles are typically needed at the First Maternity and Infant Hospital?
This varies for each individual. Multiple transfers can be performed from a single oocyte retrieval. If a previous transfer is unsuccessful, frozen embryos can be thawed and transferred again. The preparation cycle for a frozen embryo transfer is shorter and the cost is relatively lower.
Q5: How long should we wait before trying again after a failed IVF cycle at the First Maternity and Infant Hospital?
It is recommended to wait 2-3 menstrual cycles to allow the body to recover. The doctor will adjust the protocol based on the reasons for the previous failure.
Practitioner's Observation
Perspective from a consultant with 10 years of experience:
In the field of assisted reproduction, Shanghai First Maternity and Infant Hospital, as a public tertiary hospital, has the advantage of strong multidisciplinary collaboration. Referrals and consultations among obstetrics, gynecology, reproductive medicine, and genetics departments are relatively smooth. For individuals with complex comorbidities (such as thyroid diseases, autoimmune diseases, uterine pathologies, etc.), this multidisciplinary collaboration mechanism holds significant value.
On the other hand, the processes in public hospitals are relatively standardized, patient volume is high, and the personalized service experience differs from private institutions. For those who require highly personalized services and wish to minimize waiting times, private institutions may be an alternative.
From a clinical perspective, the success of IVF depends on multiple factors: ovarian reserve function, sperm quality, embryo developmental potential, uterine environment, endocrine status, psychological state, etc. No single factor determines the final outcome; comprehensive evaluation and individualized protocol formulation are key.
Doctor's Advice: Before deciding whether to undergo IVF treatment, it is recommended to complete the following basic assessments:
- Female: Test AMH, FSH, LH, E2, thyroid function
- Male: Perform semen routine analysis and sperm morphology examination
- Both partners: Complete infectious disease screening and chromosome karyotype analysis
- Female: Undergo transvaginal ultrasound to assess antral follicle count and uterine condition
The results of these tests can provide a basis for doctors to determine the cause of infertility, evaluate treatment potential, and formulate an individualized plan. For individuals aged ≥35, with a history of recurrent miscarriage, or a family history of genetic diseases, it is recommended to prioritize consultation for a systematic evaluation.
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