What Preparations Are Needed Before IVF in China? A Complete Guide to Tests and Procedures

AI Summary

Real consultation scenario opening ===== Module I: Actual Process =====

I. The Actual Process of Pre-IVF Preparation

From the initial consultation to formally entering the ovarian stimulation cycle, the following steps are usually required. Understanding the overall process helps patients plan their time effectively and avoid cycle delays due to missing documents or tests.

1. Initial Consultation and Filing: Bring both partners' ID cards, marriage certificate, and birth certificate (required in some regions) to the reproductive center to establish a file and enter basic information.
2. Ordering Tests: The doctor orders tests based on the woman's age, menstrual cycle, and medical history. Female tests are divided into menstrual phase (days 2–4) and non-menstrual phase; male tests generally have no time restrictions.
3. Completing Tests: Blood draws, ultrasounds, semen analysis, imaging studies, etc. Some tests require appointments (e.g., hysteroscopy, chromosome karyotype).
4. Report Compilation: After all test results are available, the reproductive physician evaluates whether IVF is indicated and whether any abnormalities need prior treatment (e.g., thyroid dysfunction, endometrial polyps).
5. Protocol Determination: Based on ovarian reserve, semen quality, and obstetric history, the ovarian stimulation protocol is determined (long protocol, antagonist protocol, mild stimulation protocol, etc.).
6. Signing Informed Consent: Carefully read and sign the IVF treatment consent form, embryo disposition consent form, and other documents.
7. Starting the Cycle: Initiate ovarian stimulation as instructed by the doctor after the onset of menstruation.

The entire preparation period (from initial consultation to starting the cycle) generally takes 1–3 months. If there are comorbidities requiring treatment (e.g., intrauterine adhesions, hypothyroidism), the time will be extended accordingly.

===== Module L: Test Indicator Interpretation =====

II. Key Test Items and Indicator Interpretation

Pre-IVF tests are divided into three categories: female-specific, male-specific, and tests for both partners. The table below lists the core items and their clinical significance.

Female Test Items

Test Item	Key Indicator / Normal Reference	Significance and Notes
AMH	>1.1 ng/mL (typically 2–5 for women under 30)	Assesses ovarian reserve, unaffected by menstrual cycle, can be tested anytime. AMH <0.5 indicates severely diminished ovarian reserve, requiring prompt cycle initiation.
FSH / LH	FSH <10 IU/L (menstrual cycle days 2–4)	Elevated FSH suggests decreased ovarian response. FSH >12–15 may predict fewer eggs retrieved.
Antral Follicle Count (AFC)	Total bilateral antral follicles 5–15	Counted via transvaginal ultrasound, reflects the size of the resting follicle pool. AFC <5 indicates low ovarian reserve.
Chromosome Karyotype	46, XX (normal female karyotype)	Screens for structural chromosomal abnormalities (e.g., balanced translocation, inversion). Valid for life; only needs to be done once.
Uterine Cavity Examination	Normal uterine cavity shape, no masses	Hysteroscopy or saline infusion sonography. Rules out factors affecting embryo implantation such as endometrial polyps, adhesions, fibroids, or septum.
Infectious Disease Screening	Negative for Hepatitis B, Hepatitis C, Syphilis, HIV	Valid for 6 months. Positive results require specialist evaluation; in some cases, cycles can proceed with a mitigation plan.
Thyroid Function	TSH <2.5 mIU/L	Hypothyroidism or subclinical hypothyroidism increases miscarriage risk; requires medication adjustment beforehand.

Male Test Items

Test Item	Key Indicator / Normal Reference	Significance and Notes
Routine Semen Analysis	Concentration ≥15×10⁶/mL, PR ≥32%	Abstain for 2–7 days. Assesses sperm count, motility, and morphology. If abnormal, repeat testing or add sperm DNA fragmentation test.
Sperm Morphology (Strict Criteria)	Normal morphology rate ≥4%	High abnormality rate may be associated with reduced fertilization, but ICSI can resolve most morphological issues.
Chromosome Karyotype	46, XY (normal male karyotype)	Screens for Y chromosome microdeletions, balanced translocations, etc. Valid for life.
Infectious Disease Screening	Negative for Hepatitis B, Hepatitis C, Syphilis, HIV	Valid for 6 months; should be done concurrently with the female partner.

===== Module J: Time Planning and Test Validity =====

III. Time Planning and Test Validity

The most common problem in pre-IVF preparation is "expired tests." The validity of different tests varies greatly, so the order of testing should be arranged according to the planned cycle start time.

• Valid for Life: Chromosome karyotype analysis (both partners), ABO blood group + Rh blood type.
• Valid for 1 Year: AMH, autoantibodies (anticardiolipin antibodies, antinuclear antibodies, etc.), genetic carrier screening (required by some centers).
• Valid for 6 Months: Infectious disease screening (Hepatitis B, Hepatitis C, Syphilis, HIV), TORCH, thyroid function, liver and kidney function, blood glucose, coagulation function.
• Valid for 3 Months: Routine semen analysis (sperm quality fluctuates; retesting is recommended after 3 months).
• Can Change at Any Time: FSH, LH, Estradiol (E2), Progesterone (P) — these hormones fluctuate physiologically across different menstrual cycles; doctors usually require retesting within 1–2 months before starting the cycle.

Recommended Timeline:

• 3–6 months before planned cycle start: Complete chromosome karyotype, AMH, genetic counseling (if applicable).
• 2–3 months before planned cycle start: Complete semen analysis, infectious disease screening, thyroid function, uterine cavity examination.
• 1 month before planned cycle start: Complete menstrual phase hormone tests (FSH, LH, E2), antral follicle count, breast ultrasound, electrocardiogram, etc.

===== Module G: Most Easily Overlooked Details =====

IV. The 5 Most Easily Overlooked Details

In clinical practice, the following details are often overlooked by patients but can directly impact the IVF process.

1. Neglecting Male Testing: Many couples believe "IVF is mainly the woman's affair" and that the man only needs one semen test. In reality, male chromosome analysis, sperm DNA fragmentation, and Y chromosome microdeletion testing significantly impact embryo quality and fertilization outcomes.
2. Not Obtaining the Birth Certificate in Advance: Some regions require a "Birth Service Registration Certificate" or similar proof. Obtaining it requires stamping from the household registration or residence family planning department, usually taking 5–15 working days. It is advisable to prepare it in advance.
3. Incomplete Past Surgical Records: If you have had surgeries such as hysteroscopy, laparoscopy, myomectomy, or ovarian cystectomy, it is best to provide the surgical records and pathology reports. The doctor needs to know if the uterine cavity shape or ovarian function has been affected.
4. Incomplete Medication History: Long-term medications (e.g., antihypertensives, hypoglycemics, antidepressants, traditional Chinese medicine, supplements) should be proactively disclosed to the doctor. Some medications may need adjustment or discontinuation, and some (e.g., Coenzyme Q10, DHEA) may interact with the stimulation protocol.
5. Unaddressed Oral Health: It is recommended to complete a dental check-up and cleaning before starting the cycle. If pulpitis or pericoronitis occurs during ovarian stimulation, medication and treatment options may be limited, and improper management could affect the cycle.

===== Module H: Common Pitfalls =====

V. The 4 Most Common Misconceptions

Based on the real experiences of many patients, the following four misconceptions most often lead to prolonged preparation time or cycle cancellation.

Common Misconception	Correct Practice	Consequence
"I'm usually very healthy, so my tests will definitely be fine."	Even without symptoms, systematic testing is necessary. Many infertility issues (e.g., balanced chromosomal translocation, high sperm DNA fragmentation) are asymptomatic.	Problems discovered only after starting the cycle, forcing a pause.
"Low AMH means I absolutely cannot do IVF."	Low AMH doesn't mean IVF is impossible; it just means fewer eggs may be retrieved. The doctor can adjust the stimulation protocol or suggest mild stimulation/natural cycle.	Giving up treatment due to anxiety, missing the optimal window.
"The man only needs one semen test."	Semen quality fluctuates; if abnormal, it should be repeated 2–3 times. It is also advisable to add sperm DNA fragmentation and morphology tests.	A single result may be misleading, affecting the choice of fertilization method.
"The faster the tests are done, the better. I need to start the cycle quickly."	Tests need to align with the menstrual cycle, and some have specific time windows. Forcing speed may lead to inaccurate results or missed key tests.	Cycle cancellation or repeat testing, ultimately taking more time.

===== Module C: Doctor's Perspective =====

VI. Doctor's Perspective: Which Preparations Are Most Important

From a reproductive physician's standpoint, the core goal of pre-IVF preparation is not "to complete all tests," but to gather enough information to formulate a safe and effective individualized plan. The following three preparations are what doctors value most:

1. Accurate Ovarian Reserve Assessment: Age + AMH + AFC are the foundation for predicting ovarian response. For women over 35, even with normal AMH, attention should be paid to annual trends in FSH and antral follicle count.
2. Assessment of the Uterine Cavity Environment: Hysteroscopy is the gold standard for diagnosing endometrial pathology. For patients with a history of intrauterine procedures (D&C, curettage, uterine surgery), decreased menstrual flow, or abnormal ultrasound findings, hysteroscopy is strongly recommended before starting the cycle.
3. Genetic Risk Assessment: If there is a history of recurrent miscarriage, family genetic disorders, or severe male factor infertility, it is advisable to complete chromosome karyotyping and genetic counseling in advance. Some genetic issues can be addressed through PGT (Preimplantation Genetic Testing), but this requires advance planning.

===== Module E: Differences Across Regions/Countries =====

VII. Differences in Pre-IVF Preparation Across Chinese Regions and Between China and Abroad

Although the National Health Commission of China has unified regulations for assisted reproductive technology, there are some differences in implementation across provinces and reproductive centers. Understanding these differences helps patients avoid being caught off guard due to regional variations.

• Differences in Document Requirements: Most centers require both partners' ID cards + marriage certificate + birth registration certificate. A few centers (especially in first-tier cities) have stricter verification of the birth certificate, requiring a stamp from the household registration or residence family planning department. It is advisable to call the target reproductive center in advance to confirm the latest requirements.
• Differences in Test Items: Some centers include genetic carrier screening (e.g., for SMA, thalassemia, deafness genes) as a routine item, while others only recommend it for high-risk populations. If planning to seek treatment in another city, you can ask in advance whether records from an external hospital are acceptable.
• Differences Between China and Abroad: Some foreign reproductive centers (e.g., in the US, Japan) have assessment standards for AMH and age that are generally consistent with China, but they place greater emphasis on male sperm DNA fragmentation. Additionally, indications for PGT are broader abroad, while China strictly limits them to indications like recurrent miscarriage, advanced maternal age, and genetic diseases. If considering overseas IVF, additional preparation of passports, visa translations, and international medical summaries is required.

For patients undergoing IVF in mainland China, the core preparation logic is to follow the requirements of the target reproductive center, as laboratory standards, protocol preferences, and quality control systems vary between centers. It is recommended to obtain a complete "pre-operative preparation checklist" during the initial consultation and verify each item.

===== Module A: Direct Answer (Summary) =====

VIII. Direct Answer: What Exactly Needs to Be Prepared Before IVF

Summarized in the most concise way:

Conclusion: Doctor's Advice

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