Detailed Guide to Assisted Reproduction in Thailand: From Initial Consultation to Embryo Transfer

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1. Core Pathway of the Assisted Reproduction Process in Thailand

The standard process for assisted reproduction (IVF/ICSI with PGT) in Thailand includes the following six consecutive stages, each with specific medical objectives and timelines:

• Stage 1: Preliminary Medical Evaluation and Registration — Complete a baseline fertility assessment (AMH, FSH, LH, E2, antral follicle count), semen analysis, chromosome karyotype, infectious disease screening (HIV, Hepatitis B, Syphilis, etc.), and uterine cavity examination (if necessary) in your home country. Simultaneously, arrange your passport, visa, select a reproductive center in Thailand, and complete remote registration.
• Stage 2: Ovarian Stimulation — Initiated on day 2–3 of menstruation, using FSH/LH medications to stimulate follicle development. The average duration is 10–14 days, with hormone levels and follicle size monitored every 2–3 days.
• Stage 3: Egg and Sperm Retrieval — Transvaginal ultrasound-guided egg retrieval is performed 34–36 hours after the hCG trigger injection. The male partner provides a semen sample (or previously frozen sperm is used).
• Stage 4: Embryo Culture and PGT Screening — After fertilization, embryos are cultured to the blastocyst stage (day 5–6). PGT-A (chromosomal aneuploidy screening) or PGT-M (monogenic disease screening) is performed, taking 14–21 days.
• Stage 5: Frozen Embryo Transfer — In the subsequent menstrual cycle, the endometrium is prepared using hormone replacement therapy or a natural cycle. When the endometrial thickness is ≥ 7 mm and morphology is good, one blastocyst is transferred.
• Stage 6: Luteal Phase Support and Pregnancy Test — Progesterone medication is continued after the transfer. A blood test for β-hCG is performed on day 12–14 to confirm pregnancy.

This pathway applies to the vast majority of individuals, but specific medications, dosages, and transfer strategies are adjusted based on age, ovarian reserve, and medical history.

2. Why Process Planning is Crucial

Assisted reproduction involves multiple interconnected steps. Delays or errors at any point can affect the outcome. Especially for cross-border medical care, non-medical factors like visas, flights, and time off work must be coordinated. From our observations, the most common process issues are:

• Expired Test Reports — Some tests (e.g., chromosome karyotype, infectious disease screening) are valid long-term, but hormone levels and AMH should be rechecked within 3–6 months.
• Insufficient Passport Validity — Thailand requires a passport validity of ≥ 6 months upon entry, and some reproductive centers need the original passport for registration.
• Unallocated Time for Male Partner — The male partner must be in Thailand on the day of sperm retrieval. If using frozen sperm, it must be prepared in advance, and sperm viability confirmed.
• Desynchronization of Endometrial Preparation and Embryo Thawing — If using a natural cycle for transfer, miscalculation of the ovulation day can mean the embryo is thawed but cannot be transferred in time.

Therefore, planning the process 2–3 months in advance, securing all tests, documents, and travel arrangements, is fundamental to ensuring smooth treatment.

3. How Doctors Evaluate the Treatment Plan

4. Process Differences Across Age Groups

Age is one of the most direct factors influencing the assisted reproduction process. The table below summarizes the main differences across three age groups:

For women over 40, Thai reproductive specialists usually recommend 1–2 months of pre-treatment before ovarian stimulation, including supplementation with Coenzyme Q10, Vitamin D, DHEA (as appropriate), and strict control of metabolic indicators like blood sugar and thyroid function.

5. Detailed Breakdown of Each Standard Stage

5.1 Preliminary Examinations and Registration

Female partner needs to complete: AMH, FSH, LH, E2, P, TSH, PRL, antral follicle count, chromosome karyotype, complete blood count, coagulation profile, infectious disease panel (4 tests), and hysteroscopy (if ultrasound suggests abnormalities). Male partner needs to complete: Semen analysis + morphology, sperm DNA fragmentation index (DFI), chromosome karyotype, and infectious disease panel. All reports must be translated into English and notarized (some centers accept scanned copies). For registration, you need to provide the passport bio-page, marriage certificate (if applicable), and previous surgical records.

5.2 Ovarian Stimulation and Follicle Monitoring

Starting on day 2–3 of menstruation, gonadotropins (Gonal-F, Puregon, Menopur, etc.) are injected. The dose is adjusted based on follicular response. A GnRH antagonist is usually added on day 5–7 to prevent a premature LH surge. The entire stimulation process requires 4–6 monitoring visits, each involving a blood test and transvaginal ultrasound. When at least 2 follicles reach ≥ 18 mm in diameter, the hCG trigger is administered, and egg retrieval occurs 34–36 hours later.

5.3 Egg and Sperm Retrieval

Egg retrieval is performed under intravenous anesthesia, lasting about 20–30 minutes. You are observed for 2 hours post-procedure and can return to your accommodation the same day. The male partner provides a semen sample on the day of retrieval. If frozen sperm was prepared earlier, its viability and quantity must be confirmed in advance. The number of eggs retrieved is directly related to AMH and age: AMH > 2.0 typically yields 10–15 eggs; AMH 0.5–1.0 yields 3–6 eggs; AMH < 0.5 may yield only 1–3 eggs.

5.4 Embryo Culture and PGT

ICSI fertilization is performed 4–6 hours after egg retrieval, and pronuclei are observed the next day. Embryos develop in sequential culture media to the blastocyst stage on day 5–6. For PGT-A, 3–5 cells are biopsied from the trophectoderm of the blastocyst and sent for NGS or aCGH analysis. PGT results are typically available in 14–21 days, during which embryos are cryopreserved. For chromosomally normal (euploid) blastocysts, the implantation rate after transfer is approximately 50–65% (varying by age and center data).

5.5 Frozen Embryo Transfer

This is usually performed in the 2nd or 3rd menstrual cycle following the egg retrieval cycle. There are two main endometrial preparation protocols: Hormone Replacement Therapy (HRT) cycle (oral estradiol + progesterone for endometrial transformation) suitable for those with ovulation disorders or thin endometrium; Natural cycle suitable for those with regular ovulation. The transfer is performed under continuous ultrasound guidance, and you rest for 30 minutes afterward before returning.

5.6 Luteal Phase Support and Pregnancy Test

Progesterone (oral, vaginal gel, or injection) is started immediately after the transfer and continued until the pregnancy test day. A blood test for β-hCG is done on day 12–14 post-transfer. If positive, luteal support continues until 8–10 weeks of gestation. If negative, menstruation usually occurs 3–5 days after stopping medication, and you can proceed to the next cycle.

6. Timeline and Cycle Planning

Below is a standard timeline for those planning to travel to Thailand:

The entire cycle from initiation to pregnancy test takes approximately 3–4 months. If multiple egg retrievals are needed, the total cycle may extend to 5–8 months. It is advisable to allow a 1–2 month buffer for repeating tests, updating documents, or medical adjustments.

7. Frequently Asked Questions

7.1 Can I still go to Thailand for treatment with low AMH?

Yes, but you need to adjust your expectations. When AMH is below 0.5, the number of eggs retrieved per cycle is usually ≤ 3. You may need 2–3 egg retrieval cycles to accumulate 2–3 euploid blastocysts. Thai doctors will use mild stimulation or natural cycle protocols to reduce medication costs and physical burden. The key is to be mentally and financially prepared in advance.

7.2 How far in advance should I prepare for IVF in Thailand?

It is recommended to start at least 2 months in advance. Use the first month to complete all tests (some results take 2–4 weeks). Use the second month to arrange your passport/visa, select a center, and complete remote registration. If test results are abnormal and require repeat testing or treatment, more time will be needed.

7.3 What are the passport validity requirements?

Your passport must be valid for at least 6 months upon entry into Thailand. Additionally, reproductive centers require a scanned copy of the passport bio-page for registration, and some centers require a validity of ≥ 12 months for future follow-up visits. Check your passport validity before departure; if it is less than 12 months, it is advisable to renew it first.

7.4 How many times does the male partner need to go to Thailand?

At least once, on the day of egg retrieval. If using frozen sperm, the male partner does not need to go to Thailand, but the sperm sample must be sent to the Thai center in advance with all necessary procedures completed. If PGT-M is required, the male partner may need to provide a blood sample for genetic site verification, requiring additional coordination.

7.5 Do I need to prepare my body before IVF in Thailand?

Basic preparation is recommended 3 months in advance: Female partner should take folic acid (400–800 μg/day), Coenzyme Q10 (200–300 mg/day), and Vitamin D (1000–2000 IU/day). Male partner should supplement with zinc, selenium, and L-carnitine. Also, maintain a healthy weight (BMI 18.5–24), have a regular sleep schedule, and quit smoking and limit alcohol. Thyroid dysfunction, hyperprolactinemia, or diabetes should be treated and stabilized first.

7.6 Is chromosome testing mandatory?

It is not mandatory, but it is strongly recommended. Chromosome karyotype abnormalities (e.g., balanced translocation, Robertsonian translocation) occur in about 0.5% of the general population and are higher among infertile individuals. If one partner carries an abnormality, PGT-SR is a necessary option. Even without a clear indication, knowing your karyotype in advance can help avoid recurrent miscarriage after transfer.

— This article is compiled based on general industry processes and clinical practice for assisted reproduction and is not intended as personalized medical advice —