Thailand IVF Process Explained: From Examination to Embryo Transfer Stages

Direct Answer: The Thailand IVF process is divided into six core stages: pre-operative examination, ovarian stimulation, egg and sperm retrieval, embryo culture and PGT screening, frozen embryo transfer, and luteal phase support. From starting the examination to confirming pregnancy, the complete cycle takes approximately 60–90 days, with the vast majority of patients arranging two trips to Thailand to complete the entire treatment.

1. Detailed Thailand IVF Process

1.1 Pre-operative Examination and Evaluation

Before starting treatment, a comprehensive fertility assessment and related examinations must be completed. The purpose is to identify the cause of infertility, develop an individualized plan, and rule out potential diseases that could affect pregnancy.

Examination Timeline Notes: Female basic endocrine and antral follicle count must be completed on days 2–4 of the menstrual cycle. AMH is not restricted by the menstrual cycle and can be tested at any time. Male semen analysis requires 3–5 days of abstinence. Chromosome testing needs to be scheduled in advance, with results taking approximately 10–14 working days. For patients with a family history of genetic diseases or adverse pregnancy history, genetic counseling is recommended simultaneously.

1.2 Ovarian Stimulation Treatment

Ovarian stimulation starts on days 2–3 of the menstrual cycle and lasts for 10–14 days. Ovarian stimulation medications include imported Gonal-f, Puregon, etc., and domestic urinary gonadotropins. The doctor selects the protocol and dosage based on age, AMH, antral follicle count, and previous response to stimulation. During stimulation, follicle development and hormone levels are monitored every 2–3 days. When the leading follicles reach 18–20mm in diameter, a trigger shot (HCG) is administered, and egg retrieval takes place 36 hours later.

1.3 Egg and Sperm Retrieval

Egg retrieval is performed under intravenous anesthesia, using transvaginal ultrasound-guided follicle aspiration. The procedure takes about 15 minutes. The number of eggs retrieved correlates with AMH and antral follicle count. On the day of egg retrieval, the male provides a semen sample. If there is difficulty or poor sperm quality, sperm can be frozen in advance or obtained via testicular sperm aspiration. After egg retrieval, patients rest for 1–2 hours before discharge and should avoid strenuous activity that day.

1.4 Embryo Culture and PGT Screening

The method of combining egg and sperm is either conventional IVF (natural fertilization) or ICSI (intracytoplasmic sperm injection). Embryos are cultured to the blastocyst stage on days 5–7. If PGT genetic screening is required, 3–5 trophectoderm cells are biopsied at the blastocyst stage to detect chromosomal abnormalities. PGT screening takes 3–4 weeks for results. After screening, embryos are cryopreserved (frozen embryos).

1.5 Frozen Embryo Transfer

The transfer is scheduled for the next menstrual cycle. Endometrial thickness and pattern are monitored starting from days 8–10 of the menstrual cycle. Transfer is arranged when the endometrial thickness reaches 7–12mm and the pattern is favorable. The transfer procedure is performed under abdominal ultrasound guidance, placing the thawed embryo into the uterine cavity. The procedure takes about 5 minutes and requires no anesthesia. After transfer, progesterone medications are used to support luteal function, administered orally, vaginally, or by injection.

1.6 Pregnancy Test

Blood is drawn 10–12 days after transfer to measure HCG levels and confirm pregnancy. If the test is positive, luteal support continues until weeks 8–10 of pregnancy. If negative, medication is stopped, awaiting menstruation, and the next steps are discussed with the doctor.

2. Timeline

• First Trip to Thailand: 14–18 days (Depart on day 2 of menstruation, complete ovarian stimulation + egg retrieval, then return home)
• Waiting Period at Home: 3–4 weeks (PGT screening results + endometrial preparation)
• Second Trip to Thailand: 5–7 days (Frozen embryo transfer + initial luteal support)
• Total Cycle Duration: 60–90 days

If choosing not to undergo PGT screening and opting for a fresh embryo transfer, only one trip to Thailand is needed (approximately 18–22 days), provided conditions such as good endometrial lining and no risk of ovarian hyperstimulation syndrome are met.

3. Factors Affecting Cost

The cost of IVF in Thailand varies significantly depending on the hospital level, stimulation protocol, type of medication, and whether PGT screening is performed. The main cost components are as follows:

• Pre-operative Examination: Approximately 3,000–6,000 RMB if done domestically (chromosome testing billed separately)
• Ovarian Stimulation Medication: Imported medication about 10,000–20,000 RMB; domestic medication about 3,000–8,000 RMB
• Egg Retrieval Surgery + Lab: Includes embryo culture, ICSI, embryo freezing, etc., about 30,000–50,000 RMB
• PGT Screening: Charged per embryo, approximately 3,000–5,000 RMB per embryo
• Frozen Embryo Transfer: About 10,000–20,000 RMB
• Translation Coordination Service: If needed, about 5,000–15,000 RMB
• Living Expenses: Accommodation, transportation, meals, etc., vary widely; typically a total of 15,000–30,000 RMB for two trips

The overall cost range is approximately between 80,000 and 160,000 RMB, with the specific amount subject to the hospital's actual quotation.

4. Most Easily Overlooked Details

• Passport Validity: Must be valid for more than 6 months. Renew it in advance if it has less than 6 months remaining.
• AMH Level Fluctuation: Long-term use of hormonal medications (e.g., birth control pills) can temporarily lower AMH levels. Retesting 3 months after stopping medication is more accurate.
• Timing of Male Examination: Semen analysis requires 3–5 days of abstinence. Too short (<2 days) or too long (>7 days) abstinence can affect sperm density and motility results.
• Chromosome Test Appointment Lead Time: Some hospitals require booking chromosome testing 1 month in advance. Arrange it as early as possible.
• Endometrial Preparation Before Transfer: For frozen embryo transfer, estrogen is used to prepare the endometrium. The entire process takes about 12–16 days, during which endometrial thickness and hormone levels are monitored.

5. Most Common Pitfalls

• Trusting Unregulated Agencies: Some agencies lack medical backgrounds, have opaque pricing, and may even engage in "secondary charges" or "bundled packages." It is recommended to directly contact a reputable Thai fertility center or choose a coordination service with genuine medical qualifications.
• Blindly Believing Success Rate Promises: "Guaranteed success" or "100% pregnancy" is not medically sound. The live birth rate of IVF is influenced by multiple factors such as age, ovarian reserve, and embryo quality. No guarantee of success exists.
• Ignoring Underlying Disease Evaluation: Conditions like thyroid dysfunction, autoimmune diseases, coagulation abnormalities, or endometrial pathology that are not treated before starting a cycle can significantly reduce pregnancy rates.
• Overexertion or Staying Up Late During Stimulation: High-intensity exercise, staying up late, and alcohol consumption can affect follicle development quality. Bed rest is not required during stimulation, but a regular routine should be maintained.
• Prolonged Bed Rest After Transfer: Normal daily activities are fine after transfer. Long-term bed rest can negatively affect uterine blood flow and endocrine status, increasing the risk of thrombosis.

6. Special Situation Management

Low AMH (<1.0 ng/mL)

Low AMH does not mean there is no chance, but a more precise protocol is needed. The fertility doctor may use a mild stimulation or antagonist protocol to reduce medication dosage and improve follicle utilization. Some patients may need 2–3 stimulation cycles to accumulate embryos before unified screening and transfer. When AMH is below 0.5 ng/mL, it is advisable to fully assess ovarian response before deciding whether to start a cycle.

Advanced Maternal Age (Female ≥38 years)

Increasing age leads to a higher rate of chromosomal aneuploidy in eggs. For patients over 38, routine PGT screening is recommended to select chromosomally normal embryos for transfer, reducing the risk of miscarriage and birth defects. A comprehensive evaluation of baseline health conditions such as heart, liver, kidney function, blood sugar, and blood pressure is also necessary.

Recurrent Implantation Failure

After two or more failed transfers of good-quality embryos, the following investigations are recommended: hysteroscopy (to rule out polyps, adhesions, endometritis), ERA endometrial receptivity test, immune factor assessment (NK cells, antiphospholipid antibodies, etc.), and coagulation function tests. After identifying the cause and providing targeted treatment, consider the next transfer.

Male Azoospermia

Sperm can be obtained via testicular sperm aspiration or microdissection TESE. If no usable sperm is obtained, donor sperm is required. The source of donor sperm must comply with Thai health department regulations, involving donor identity information and genetic disease screening.

7. Frequently Asked Questions