IVF at the Third Affiliated Hospital of Guangzhou Medical University: Real Process and Cost Explanation

Scene Opening (Type 1: Real Consultation Scenario)

Overall Situation of IVF at the Third Affiliated Hospital of Guangzhou Medical University

The Reproductive Medicine Center of the Third Affiliated Hospital of Guangzhou Medical University is one of the early institutions in South China to carry out assisted reproductive technology. In 1989, the first successful IVF baby in Guangdong Province was born here. Currently, the center has the technical qualifications for artificial insemination with husband's sperm, artificial insemination with donor sperm, first-generation IVF (IVF-ET), second-generation IVF (ICSI), and third-generation IVF (PGT).

For conditions such as tubal factors, ovulation disorders, endometriosis, male factors, and unexplained infertility, the center has corresponding diagnostic and treatment pathways. After a patient's visit, the doctor will develop an individualized treatment plan based on the specific cause, age, ovarian reserve, and other factors. Overall, the Third Affiliated Hospital of Guangzhou Medical University has accumulated rich clinical experience in the field of assisted reproduction, with a mature technical system and strong multidisciplinary collaboration capabilities.

How Doctors Evaluate IVF

At the Third Affiliated Hospital of Guangzhou Medical University, doctors do not simply give a conclusion of "can do" or "cannot do." Instead, they conduct a systematic evaluation, which specifically includes the following four aspects:

• Ovarian Reserve Assessment: Comprehensive assessment of ovarian responsiveness using indicators such as AMH, FSH, LH, E2, and antral follicle count (AFC). AMH is an important indicator for evaluating ovarian reserve. Low AMH does not mean IVF cannot be done, but it suggests the need for a more individualized ovulation induction protocol.
• Uterine Environment Assessment: Evaluation of endometrial morphology, thickness, and any lesions through B-ultrasound, hysteroscopy, etc. If the endometrial thickness is less than 7mm or there are conditions like intrauterine adhesions or polyps, these need to be addressed first.
• Sperm Quality Assessment: The male partner needs to undergo semen analysis, and if necessary, additional tests such as sperm DNA fragmentation rate and acrosome reaction. A high sperm DNA fragmentation rate may affect embryo development and implantation.
• General Health Assessment: Includes thyroid function, coagulation function, infectious disease screening, chromosome karyotype, etc. Abnormal thyroid function or coagulation function requires intervention first.

Based on these results, the doctor determines which type of technology is suitable for the patient, as well as the expected ovarian response and pregnancy probability. The evaluation process usually takes 1-2 weeks, and some test results may require a longer waiting time.

Differences and Management Strategies for Different Age Groups

Age is one of the core factors affecting IVF success rates. The management strategies for patients of different ages at the Third Affiliated Hospital of Guangzhou Medical University are significantly different, as shown in the table below:

For patients under 35 with normal ovarian function, a conventional ovulation induction protocol is usually adopted, and the pregnancy rate with fresh cycle transfer is relatively high. For patients over 40, doctors recommend preimplantation genetic testing for aneuploidy (PGT-A) to reduce the risk of implantation failure or miscarriage caused by embryonic chromosomal abnormalities.

For individuals with low AMH, the Third Affiliated Hospital of Guangzhou Medical University uses mild stimulation or natural cycle protocols to minimize excessive ovarian stimulation and strive to obtain high-quality eggs.

Differences Between the Third Affiliated Hospital of Guangzhou Medical University and Other Hospitals

In the Guangzhou area, several hospitals offer assisted reproductive technology, each with its own characteristics. Patients can choose based on their individual circumstances:

• Third Affiliated Hospital of Guangzhou Medical University: The oldest, with the first successful IVF baby in Guangdong Province born here in 1989. It has comprehensive technical qualifications (first, second, and third-generation IVF), strong research capabilities, and a large patient volume. It collaborates closely with gynecology, obstetrics, andrology, and genetics departments, making it suitable for patients requiring multidisciplinary diagnosis and treatment.
• First Affiliated Hospital of Sun Yat-sen University: Also a well-established reproductive center with extensive experience in handling complex cases, particularly skilled in treating recurrent implantation failure and recurrent miscarriage.
• Guangdong Maternal and Child Health Hospital: Has advantages in genetic counseling and prenatal diagnosis, suitable for patients with a genetic background or those needing prenatal diagnosis.
• Nanfang Hospital of Southern Medical University: Has distinctive features in the diagnosis and treatment of reproductive endocrine diseases, such as polycystic ovary syndrome and premature ovarian failure.

One characteristic of the Third Affiliated Hospital of Guangzhou Medical University is the close collaboration between its Reproductive Medicine Center and departments such as gynecology, obstetrics, andrology, and genetics. For patients with multidisciplinary issues, joint diagnosis and treatment can be arranged. Additionally, the center has considerable experience in the diagnosis and treatment of recurrent miscarriage.

Actual Process: From Initial Consultation to Pregnancy Test

The standard process for IVF at the Third Affiliated Hospital of Guangzhou Medical University is roughly divided into the following steps, each with specific timing and precautions:

Step 1: Initial Consultation

• Timing: Days 2-5 of menstruation (best to visit in the morning on an empty stomach).
• Content: Doctor's consultation, issuing examination orders, preliminary assessment.
• Preparation: All previous medical records (including surgical records, hysterosalpingography reports, semen analysis, etc.), and identification cards of both partners.

Step 2: Complete Examinations

• Female Examination Items: AMH, sex hormone panel (checked on days 2-3 of menstruation), thyroid function, coagulation function, infectious disease screening (Hepatitis B, Hepatitis C, Syphilis, HIV, etc.), chromosome karyotype, B-ultrasound (antral follicle count, endometrial assessment), hysteroscopy (if necessary).
• Male Examination Items: Semen analysis (2-3 times), sperm DNA fragmentation rate, acrosome reaction, infectious disease screening, chromosome karyotype (if necessary).
• Timing: About 1-2 months. Some tests have time constraints (e.g., chromosome karyotype results take 2-3 weeks).

Step 3: File Creation

• Materials: Original and photocopy of identification cards for both partners, original and photocopy of marriage certificate, originals of all examination reports.
• Content: Signing informed consent forms, determining the ovulation induction protocol, creating an electronic medical record file.
• Precautions: Ensure all examination results are complete before file creation, especially chromosome karyotype and infectious disease screening.

Step 4: Ovarian Stimulation

• Timing: About 10-14 days, daily injections of ovulation induction medication (domestic or imported).
• Monitoring: B-ultrasound and blood tests every 2-3 days to monitor follicle development and hormone levels.
• Precautions: Strictly follow the doctor's instructions for medication; do not stop or adjust the dosage on your own.

Step 5: Egg Retrieval

• Timing: After follicles mature (approximately 36 hours after HCG injection).
• Method: Transvaginal B-ultrasound-guided follicle aspiration, under intravenous anesthesia, painless.
• Duration: About 15-20 minutes, with a 1-2 hour observation period before discharge.

Step 6: Embryo Culture

• Timing: 3-6 days, depending on the culture protocol (cleavage stage or blastocyst).
• Content: In vitro fertilization, embryo observation, PGT testing if necessary.
• Precautions: Blastocyst culture requires good embryo quality; some embryos may stop developing during culture.

Step 7: Embryo Transfer

• Timing: 3-5 days after egg retrieval (fresh transfer) or in a subsequent cycle (frozen embryo transfer).
• Content: Transferring the embryo into the uterine cavity, the process takes about 5 minutes, painless.
• Precautions: A full bladder is needed before transfer to facilitate B-ultrasound positioning.

Step 8: Luteal Support and Pregnancy Test

• Luteal Support: Use of progesterone medications (injection or vaginal) after transfer, continuing for 12-14 days.
• Pregnancy Test: Blood test for HCG 12-14 days after transfer to determine pregnancy.
• Precautions: Do not use home pregnancy tests before the scheduled blood test to avoid emotional fluctuations affecting endocrine balance.

Common Pitfalls to Avoid

During the actual consultation process, there are several stages where patients are prone to problems and need to pay special attention:

• Creating a file with incomplete examinations: Some patients rush to create a file before all test results are available. However, missing key examinations (such as chromosome karyotype, hysteroscopy) may affect the accuracy of the subsequent treatment plan and even lead to treatment interruption. Be sure to wait until all test results are complete before creating the file.
• Neglecting male factors: Some patients think "the man is fine" and only do basic tests. In reality, specialized tests like sperm DNA fragmentation rate and acrosome reaction significantly impact embryo development and implantation. Male examinations should be done simultaneously with female ones.
• Over-focusing on follicle count: Follicle count does not equal egg quality, let alone embryo count. Some patients get anxious when they see few follicles, but in reality, if the egg quality is good, even one high-quality embryo can lead to success. Doctors place more importance on egg quality and embryo development potential.
• Excessive bed rest after transfer: Prolonged bed rest is not beneficial for embryo implantation and may increase the risk of thrombosis. After transfer, normal activity is fine; avoid strenuous exercise, but absolute bed rest is not required.
• Frequently changing doctors: Each doctor has different medication habits and management strategies. Frequently changing doctors can lead to an inconsistent treatment plan and waste time. It is recommended to stick with one primary doctor for the entire process.
• Stopping or adjusting medication on your own: Ovulation induction and luteal support medications must be used strictly according to the doctor's instructions. Stopping medication on your own may lead to cycle cancellation or pregnancy failure.

Factors Influencing Cost

The cost of IVF at the Third Affiliated Hospital of Guangzhou Medical University varies due to individual differences and the type of technology used. The main influencing factors include:

• Ovulation Induction Medication: Imported medications are more expensive, while domestic medications are relatively cheaper. The dosage varies from person to person; women with normal ovarian function require lower doses, while those with diminished ovarian reserve may need higher doses.
• Type of Technology: First-generation IVF (IVF-ET) has the lowest cost. Second-generation IVF (ICSI) adds the cost of intracytoplasmic sperm injection. Third-generation IVF (PGT) adds the cost of preimplantation genetic testing.
• Embryo Culture: Whether blastocyst culture or assisted hatching is needed will increase the corresponding costs.
• Frozen Embryo Transfer: If embryos need to be frozen, there will be a cryopreservation fee; subsequent frozen embryo transfer cycles require additional payment.
• Multiple Egg Retrievals: Some patients need multiple egg retrievals to accumulate embryos, which increases the cost accordingly.
• Other Items: Such as hysteroscopy, endometrial receptivity analysis (ERA), immunotherapy, etc., may require additional expenses depending on individual circumstances.

The specific cost range needs to be determined based on individual circumstances and the treatment plan. It is recommended to ask the doctor or financial staff for detailed information during the initial consultation and request a detailed cost breakdown.

Frequently Asked Questions

Below are some of the most common questions patients ask, for your reference:

Q: How long does the entire cycle take?

From the initial consultation to completing the transfer, if everything goes smoothly, it takes about 2-3 months. If PGT testing or frozen embryo transfer is needed, the time will be extended to 4-6 months. The specific time depends on the examination progress, ovarian response, and embryo culture results.

Q: Is egg retrieval painful?

Egg retrieval is performed under intravenous anesthesia and is completely painless. After the procedure, there may be mild abdominal pain or bloating, which usually resolves in 1-2 days. A very small number of people may develop Ovarian Hyperstimulation Syndrome (OHSS), which requires close monitoring.

Q: What is the success rate?

The success rate is related to multiple factors such as age, ovarian function, embryo quality, and uterine environment, and varies greatly between individuals. The doctor will provide an individualized expectation based on the specific situation. The overall pregnancy rate at the Third Affiliated Hospital of Guangzhou Medical University is within a reasonable range compared to other reproductive centers of the same level in China.

Q: How much time off work is needed?

During the ovulation induction period, frequent follow-up visits are required (approximately every 2-3 days). Egg retrieval and embryo transfer each require one day. It is recommended to set aside 1-2 months of flexible time, especially for patients from other cities who need to plan accommodation and transportation in advance.

Q: What does the male partner need to do?

The male partner needs to undergo semen analysis and related tests. On the day of egg retrieval, a semen sample is needed. If he cannot come to the hospital, sperm can be frozen in advance. Additionally, the male partner should maintain a healthy lifestyle during the treatment period, quit smoking and alcohol, and avoid high-temperature environments.

Q: Can I still do IVF if my AMH is low?

Low AMH does not mean IVF is impossible, but it indicates diminished ovarian reserve, requiring a more individualized ovulation induction protocol (such as mild stimulation or natural cycle). The doctor will comprehensively assess based on AMH level, age, and previous treatment response to develop a reasonable egg retrieval strategy.

Q: What should I pay attention to after the transfer?

After the transfer, live a normal life and avoid strenuous exercise and heavy physical labor. Prolonged bed rest is not necessary, but ensure adequate sleep. Maintain a balanced diet, avoiding raw, cold, and spicy foods. Use luteal support medications as prescribed by the doctor and do not stop them on your own.