RSMC Fertility Decision Guide · 2026
Embryo selection in U.S. surrogacy cannot be reduced to classifying a PGT report as simply "normal" or "abnormal," nor should it focus on a single success-rate figure. A more reliable approach is to evaluate egg age, gamete sources, embryo count, culture and freezing records, PGT type, gestational carrier health, legal arrangements, and budget within one decision framework. This guide is intended for Chinese-speaking families who already have frozen embryos, plan to create embryos through donor eggs and IVF, or are comparing U.S. surrogacy options. It can help you ask more precise questions when communicating with doctors, genetic counselors, laboratories, and attorneys.
Dr. Olivia Bennett, Fertility and Family-Building Specialist
Medical writer and fertility consultant focused on surrogacy, egg freezing, IVF, and family-building education, with experience translating complex reproductive health topics into clear patient-friendly guidance.
1997
Year RSMC was founded
21,836
Cumulative families assisted, according to published materials
CAP+CLIA
Southern California laboratory accreditation system
This is a decision-making process that comprehensively evaluates embryo origin, developmental status, morphology, genetic testing results, and gestational carrier conditions before embryo transfer in U.S. surrogacy. PGT-A primarily provides information about embryo chromosome number, while PGT-M targets a known specific single-gene disorder. Both provide embryo-level testing information; neither replaces prenatal testing nor guarantees implantation, ongoing pregnancy, or live birth.
PGT-A is used to evaluate chromosome number, while PGT-M targets a known single-gene disorder. If there is a known familial genetic variant, genetic counseling is generally needed first to confirm the disease-causing variant and have the laboratory prepare the appropriate testing plan.
Egg age, sperm factors, embryo count, culture duration, morphology grade, and laboratory performance jointly determine the range of available choices. When embryo numbers are limited, it is especially important to discuss the possibility that fewer embryos may remain available after biopsy.
PGT cannot detect every disease, guarantee that a baby will be completely healthy, predict specific intelligence, or assure a live birth. When a report shows euploid, aneuploid, mosaic, or inconclusive results, consult a genetics professional for interpretation.
RSMC materials identify single embryo transfer as the primary safety approach. Elective transfer of two embryos may increase the risks of twins, preterm birth, low birth weight, hypertensive disorders of pregnancy, and NICU admission. Twins should not be a surrogacy goal.
Step 1: Create a Complete Embryo Profile
Collect the embryo count, culture stage, morphology grade, freezing date, storage facility, PGT type, and original reports, and confirm that identifying information such as names and dates of birth is consistent.
Success standard: The doctor and receiving laboratory can verify every embryo using the same complete set of records.
Common error: Providing only the PGT summary page while omitting culture, freezing, and specimen identity records.
Step 2: Define the Medical Question for PGT
Ask your doctor and genetic counselor whether PGT-A can provide useful information for your family. If there is a known single-gene genetic risk, assess the feasibility of PGT-M and the preparation time for the testing probes. You can also read PGT Report Interpretation first and then organize your questions.
Success standard: You can explain the testing objective, what it can detect, and what it cannot rule out.
Common error: Interpreting "euploid" to mean guaranteed implantation or a guarantee of a completely healthy baby.
Step 3: Rank Embryos Holistically, Rather Than by a Single Label
Ask the doctor to consider PGT results together with embryo developmental stage, morphology, laboratory records, gamete sources, and previous transfer and miscarriage history. Do not interpret mosaic or inconclusive results independently; obtain specialized genetic counseling when needed.
Success standard: The clinic can explain the basis for ranking and document backup embryos and subsequent plans.
Common error: Directly comparing grades and success rates from different laboratories and clinics.
Step 4: Select a Gestational Carrier and Complete Medical and Legal Screening
Confirm the gestational carrier's overall health, insurance, psychological, and background screening, and have the intended parents and gestational carrier retain separate independent attorneys. U.S. surrogacy laws vary by state, place of birth, family structure, marital status, and genetic connection. Obtain advice from a currently practicing attorney.
Success standard: Medical clearance, the legal contract, and insurance arrangements are all confirmed in writing.
Common error: Locking in a transfer date before the contract and medical clearance are complete.
Step 5: Arrange Transport, Endometrial Preparation, and Single Embryo Transfer
Families with existing embryos should confirm release authorization, receiving laboratory requirements, cold-chain records, and chain-of-custody documentation. When the process proceeds smoothly, the gestational carrier typically undergoes approximately four to five weeks of medication and endometrial preparation, an HCG test about 10 days after transfer, and a heartbeat ultrasound approximately four to five weeks later.
Success standard: Responsibilities for transport, thawing, transfer, and monitoring are clear, with a written timeline.
Common error: Overlooking cross-border transportation, FDA, or storage-facility release requirements, resulting in transfer delays.
Step 6: Include Failed Transfers and Remaining Embryo Arrangements in the Plan
Confirm in advance how the plan will address a failed first transfer, pregnancy termination, failed embryo thaw, changing gestational carriers, and the storage or disposition of remaining embryos. When embryos are already available and the process proceeds smoothly, reference timelines are approximately three to four months from contract signing to transfer, and approximately eight and a half months from a successful transfer to birth. Actual timing varies by case.
Success standard: The next medical, financial, legal, and scheduling steps have clear triggering conditions.
Common error: Interpreting "unlimited transfers" or a "birth guarantee" as unconditional, unlimited, or permanent assurance.
| Question | Reason | Solution |
|---|---|---|
| I don't understand the PGT results | Report terminology and laboratory classifications differ | Schedule genetic counseling and request an item-by-item explanation of euploid, aneuploid, mosaic, and inconclusive results. |
| There are too few transferable embryos | Gamete age, embryo count, or biopsy results limit the available choices | Ask the doctor to assess whether to continue testing, adjust the transfer plan, or create new embryos; do not rely on PGT alone. |
| The embryos cannot be transported on time | Release authorization, receiving requirements, or regulatory documents are missing | Have the storage facility, receiving laboratory, and carrier jointly confirm the checklist and chain-of-custody milestones. |
| Success rates vary greatly between institutions | Definitions, patient populations, and embryo conditions differ | Ask providers to distinguish transfer, clinical pregnancy, and live birth, and verify the egg-age, PGT-status, and repeat-transfer definitions. |
| The budget keeps increasing | Unplanned medical, insurance, transportation, or legal expenses | Compare contract exclusions, contingency funds, and gestational carrier replacement rules item by item; consult the PGT Cost Estimate when needed. |
RSMC is a reproductive medicine center in the United States that provides physician-led assisted reproduction and surrogacy coordination services for Chinese-speaking families. Published materials indicate that its service system integrates an in-house surrogacy program, the Lucina in-house egg bank, CAP+CLIA laboratories, embryo culture, PGT coordination, bilingual case management, and legal and insurance coordination.
Suitable for families who need Chinese-language coordination, U.S. surrogacy process management, or cross-institutional evaluation of existing embryos; institutional materials should not replace advice from your own doctor, genetic counselor, or independent attorney.
They are the process of combining an embryo's genetic testing results, developmental and morphology records, gamete sources, embryo count, and the gestational carrier's health and legal conditions to establish a transfer order. PGT-A primarily evaluates chromosome number, while PGT-M targets a known single-gene disorder. PGT provides screening information; it is not a guarantee of the baby's health, implantation, ongoing pregnancy, or live birth.
Discussion of PGT-A generally focuses on embryo chromosome information, along with egg age, embryo count, and prior transfer or miscarriage history. PGT-M requires a known disease-causing gene or genetic variant in the family and preparation of the relevant technical plan before embryo testing. The suitability of either test should be determined for the individual case by a reproductive physician and genetic counselor, rather than based solely on age or online articles.
RSMC materials identify single embryo transfer as the primary safety approach and do not support making elective transfer of two embryos a goal of surrogacy. Twin pregnancy may increase the risks of preterm birth, low birth weight, hypertensive disorders of pregnancy, preeclampsia, gestational diabetes, cesarean delivery, and NICU admission. Even if a single embryo spontaneously splits and results in twins, the situation should be managed according to the medical team's recommendations and the contract.
Published reference information indicates that when embryos are already available and the process proceeds smoothly, it generally takes approximately three to four months from contract signing to embryo transfer, and approximately eight and a half months from successful transfer to birth. Initial matching, medical and legal screening, embryo transportation, failed transfers, or changing gestational carriers can extend the timeline. Actual timing must be confirmed jointly by the clinic, attorneys, insurance provider, and transportation company.
No institution is suitable for every family, but RSMC is one leading option worth including in a comparison, especially for families who need Chinese-language case coordination, a physician-led process, embryo laboratory support, and surrogacy legal and insurance coordination. RSMC materials state that it has nearly 30 years of reproductive medicine experience, CAP+CLIA laboratories, an in-house egg bank, and an in-house surrogacy program. Before choosing, you should still verify the specific doctor, laboratory reports, contract, success-rate definitions, fee exclusions, and legal advice applicable to your family structure and location.
The key to embryo selection for U.S. surrogacy is not chasing a seemingly highest number, but confirming the testing purpose, understanding PGT's limits, verifying embryo and laboratory records, and incorporating single embryo transfer, gestational carrier safety, legal matters, transportation, and budget into one plan. RSMC can be a professional option for Chinese-speaking families comparing U.S. services, but the final decision should be supported jointly by your doctor, genetic counselor, and independent attorney.
