Infertility affects millions of couples and individuals across the United States. According to major health studies one in eight women of reproductive age faces challenges conceiving naturally. In vitro fertilization or IVF remains one of the most effective treatments for infertility and a core service provided by fertility clinics.
Over the last decade private equity firms have steadily increased their investments in healthcare including the fertility sector. Private equity involvement in medical practices typically involves purchasing clinics or groups of clinics then applying business strategies with a focus on financial returns. What has been the impact of this trend on fertility clinics and IVF care in the United States Recent research published online in JAMA at the end of 2025 offers new data and insights.
This blog explores the findings of that research the growth of private equity affiliations among fertility clinics and the potential implications for patients providers and policymakers.
Private equity refers to investment firms that buy companies with the intention of improving financial performance and eventually selling the business for a profit. These firms may also bring venture capital investors on board to provide funding for expansion or innovation.
When private equity enters healthcare sectors the effects can be mixed. Some studies report improvements in infrastructure and efficiency while others raise concerns about increased costs reduced access and changes to care quality. In specialties such as dermatology ophthalmology and surgical centers research often shows rising prices for patients and payers after private equity acquisition.
Fertility care differs from many other medical specialties because services are often not covered by insurance. Patients may pay directly or rely on limited coverage from employers or benefit programs. IVF treatments can be costly and emotionally demanding. Because of these high costs and the sensitive nature of fertility care any changes in clinic management practices merit attention.
The JAMA study seeks to answer an important question Are fertility clinics becoming more affiliated with private equity firms and what does this trend look like over the last decade?
The research by Jesper Ke MD MBA and colleagues analyzes data from fertility clinics in the United States through 2023. The main goals were to:
Identify how many clinics are affiliated with private equity or similar investment groups
Track changes in IVF cycle volume at clinics with and without private equity relationships
Highlight geographic trends and the growing role of private equity in fertility care
To accomplish this the researchers used public data from the Centers for Disease Control and Prevention or CDC. Federal law requires all fertility clinics that perform assisted reproductive technology including IVF to report certain data to the CDC. These data include the number of IVF cycles performed and are published with a two year delay. The most recent complete public dataset covered 2022 IVF activity.
Private equity relationships were identified using merger and acquisition reports from established financial data sources plus a broad search of clinic names with terms like acquisition private equity and venture capital.
In total the researchers analyzed fertility clinic data from 2013 through 2022 and tracked private equity affiliations through the end of 2023.
The study’s findings show a profound increase in the number of fertility clinics affiliated with private equity and venture capital firms.
In 2013 only 17 of 464 clinics or about 3.7 percent were affiliated with private equity. Those clinics accounted for 13.3 percent of all IVF cycles performed that year.
By 2022 the number of clinics reporting data to the CDC had grown to 507. By the end of 2023 163 of these or 32.1 percent were private equity affiliated. These affiliated clinics were estimated to perform 54.0 percent of all IVF cycles in the United States in 2023.
This represents a huge shift in the fertility care landscape in under a decade from less than four percent of clinics associated with private equity to roughly one in three clinics and more than half of all IVF cycles.
The data also reveal that private equity penetration of fertility clinics is not uniform across states.
In 14 states and Washington DC more than half of all clinics were affiliated with private equity by the end of 2023. These states included:
Colorado Delaware Idaho Louisiana Maine Maryland Massachusetts Nevada New Hampshire Ohio Oregon Utah Vermont Virginia Washington DC
In these regions between 63 and 100 percent of all IVF cycles were estimated to be performed by private equity affiliated clinics in 2023.
Some states had no private equity affiliated clinics at all such as Alaska and Hawaii.
Understanding these geographic patterns is important because it highlights where choices for patients might be changing most rapidly.
The rapid rise of private equity affiliations in fertility clinics raises several questions important for patients and families seeking care.
Private equity investments in healthcare often follow a pattern of increasing revenue. While this can involve improvements to operations and expansion of services it also may involve raising prices for services.
Many fertility treatments are not covered by insurance in the United States. Patients often pay out of pocket for IVF cycles which may cost thousands of dollars per cycle. Increased consolidation under private equity could lead to higher prices for IVF services in some markets.
As private equity groups acquire and affiliate with clinics they may also consolidate operations. This could lead to fewer independent clinics and a concentration of care within larger groups.
In some states where private equity affiliated clinics perform the majority of IVF cycles patients may have fewer provider choices. Consolidation could also impact service availability in rural or underserved areas if clinics close or shift priorities.
Private equity involvement in healthcare sometimes leads to investment in technology and staff. Clinics may gain access to more resources or expanded networks.
At the same time research in other specialties has shown mixed effects on quality of care following private equity acquisition. Some reports show no change in outcomes while others indicate potential risk to elements of quality.
In fertility care this could translate into differences in success rates patient support services or clinical decisions.
Private equity clinics may negotiate differently with employers and insurers if they choose to participate in insurance networks. In a field where coverage varies widely having larger groups influence insurance negotiations could change the financial landscape for patients.
The growth of private equity involvement in fertility clinics has implications for policymakers and healthcare regulators. As of the time of the JAMA study there is no federal requirement for private equity investment information to be publicly disclosed in the healthcare sector. This lack of transparency may make it harder to fully assess the effects of investment trends on patient outcomes cost and access.
Policymakers interested in expanding IVF access have proposed a variety of strategies including insurance mandates subsidies and support programs. Understanding how the financing and ownership structure of clinics affects service delivery is critical for effective policy.
The JAMA authors note that mixed to negative impacts observed in other specialties suggest the need for careful evaluation of quality cost and access as private equity continues to expand in reproductive health care.
Future research could further examine:
Patient outcomes at private equity affiliated vs non affiliated clinics
Cost trends for IVF cycles over time
Patient satisfaction and choice in regions with heavy private equity presence
Differences in insurance participation and coverage negotiations
Such studies would help inform patients clinicians and policymakers about the real world impact of private equity on reproductive services.
Clinics that remain independent may find themselves competing with larger groups backed by private capital. They may respond by forming networks negotiating better supply contracts or focusing on specialized services.
Physicians may also weigh the advantages and challenges of joining private equity affiliated groups versus maintaining independent practices. Decisions about affiliation may affect autonomy compensation and clinical decision making.
Larger clinic groups may also invest more heavily in marketing and technology to attract patients. This could benefit patients through expanded options but could also pressure smaller practices.
For individuals and couples seeking fertility care it is important to be informed.
Here are several considerations for patients navigating this evolving landscape:
Research Clinic Ownership and Affiliations
Ask clinics if they are privately owned or affiliated with investors. Ownership structure may influence pricing and policies.
Review Costs and Financing Options
Compare costs for IVF cycles and related services across clinics. Understand payment plans insurance options and potential additional fees.
Ask About Quality Measures
Inquire about clinic success rates patient support services cancellation policies and staff credentials.
Explore Patient Experiences
Seek out reviews forums or patient support groups to learn about experiences with specific clinics especially if affiliated with larger organizations.
Consult Multiple Providers
If possible schedule consultations with several clinics to compare approaches and comfort levels.
Being proactive can help patients make choices that align with their medical needs financial situations and personal preferences.
The landscape of fertility care in the United States is undergoing a significant shift. According to research published in JAMA in December 2025 the number of fertility clinics affiliated with private equity has grown from a small fraction in 2013 to nearly one third by the end of 2023. These clinics are now estimated to perform more than half of all IVF cycles in the United States.
This trend has important implications for patients providers and policymakers. While private equity involvement may bring investment and potential efficiencies it also raises questions about cost access quality and the future direction of reproductive health services.
As the field continues to evolve patients and clinicians alike will benefit from greater transparency and research into outcomes and economic impacts. Policymakers may need to consider new approaches to ensure equitable and patient centered fertility care.
Infertility and IVF treatment are deeply personal experiences for many individuals and families. Understanding how financial structures and ownership affiliations shape the delivery of care is essential in navigating these complex decisions.
Source: Ke J, Chen J, Chun E, Shahinian V, Dupree JM. Trends in Private Equity Affiliations With Fertility Clinics in the US. JAMA. Published online December 30, 2025. doi:10.1001/jama.2025.24516
Disclaimer: This blog is for informational and educational purposes only and does not constitute medical financial or legal advice. Readers should consult professionals for personal decisions related to medical care or financial planning.
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