Fertility clinics see explosive growth in private equity money: study

New research shows that the US has seen a massive expansion of private equity-linked fertility clinics since 2013.

The peer-reviewed research published in the Journal of the American Medical Association December 2025 found that more than half of IVF cycles in the US in 2023 were performed at clinics affiliated with private equity firms, or investment funds that raise capital to acquire and manage companies.

Researchers examined the relationship between private equity firms and fertility clinics in the US between 2013 and 2023. They found that in 2013, less than 4 percent of fertility clinics were affiliated with private equity firms, but in the decade that followed, the number of private equity-linked clinics soared. By the end of 2023, 32 percent of the approximately 500 clinics that shared data with the U.S. Centers for Disease Control and Prevention in 2022 were affiliated with private equity firms. In 14 states and Washington DC, 50 percent of fertility clinics surveyed had ties to private equity at the end of 2023.

This increase in private equity involvement comes amid a increased attention to US fertility rates.

Fertility rates are declining in the US since the early 2000s. In 2024, the US achieved its goal lowest fertility rate everwith approximately 1.6 children per woman. And on the 2024 campaign trail, current President Donald Trump said he would expand access to IVF (in vitro fertilization).– a promise that remains unfulfilled.

Research into private equity relationships in other medical specialties has shown mixed effects on the quality of care, including poorer nurse staffing and hiring of less experienced providers. Private equity has also been linked to higher costs for patients and insurance companies.

Rewire News Group spoke with one of the authors of the article, Infertility specialist from the University of Michigan Dr. James Dupreeon the growing role of private equity in American reproductive care and the impact it could have on fertility patients.

The following interview has been edited for length and clarity.

What was your most important finding?

What struck me most was that, at least based on 2022 and 2023 data, it appears that more than half of IVF cycles in the US are now performed at clinics affiliated with private equity firms. We felt that private equity firms were affiliated with many clinics that perform IVF, but I don’t think we knew exactly how many were affiliated as it stands, nor did we have any idea of ​​the extent of IVF care being done at those clinics.

Your research notes the potential for private equity involvement in fertility care to impact patient and insurer costs and the quality of care. What would that look like?

In the field of fertility, we don’t know anything about that balance between benefits and risks for patients. To my knowledge, that research has not been done. That’s very important research to be done, but I haven’t seen any results that speak to that in the fertility field.

Other researchers examining other areas of medicine have found that the cost of care can rise – both for the patient and the insurer. There is limited research to suggest that there may be some benefits to patients: quality of care, outcomes of care. A slightly larger body of research suggests mixed or potentially harmful outcomes for patients associated with these types of preferences. But again, it’s important to emphasize that research has been done in other areas of medicine outside of fertility care.

Incentives can change as the medical practice owner changes, and those incentives can encourage physicians and other people in the clinic to perhaps update or improve the way they practice for the benefit of patients. Direct or indirect incentives are unlikely to be introduced [are] intended to harm patients. I think that’s very unlikely. But it is possible that incentives are introduced that could have unintended consequences, or unintended effects on patients.

What should patients already receiving fertility care know, consider or worry about if a private equity firm acquires their clinic?

I don’t think we’ve seen any research yet that tells us what patients should be concerned about [private equity ownership] in their clinic. It is important to recognize that there may also be benefits to private equity firms joining fertility clinics. That is certainly possible.

For example, it is expensive to run a laboratory that does IVF. It takes a lot of very expensive equipment, a lot of training, and a lot of quality improvement efforts to run an IVF laboratory. You can imagine…when [a private equity firm] enters and joins a clinic, it will invest capital, and that capital could be used to improve laboratory equipment. It can be used to implement quality improvement structures or to provide additional training for staff.

So there can definitely be advantages too. I’m not ready to say that there is anything that patients should be concerned about because I don’t think that has been proven yet. I think it needs to be investigated. It’s important to look at, given what has been seen in other parts of medicine. But it is still too early to say that there are concerns.

If you could do further research into one aspect of this problem that you cannot explain, what would it be and why?

Personally, I strongly believe that patients should have access [fertility] concern. I’d like to know, after a clinic affiliates with a private equity firm, does that improve their access, or does it limit their access in any way? That research has not been done. One might imagine that with the capital coming from a private equity firm, clinics could open satellite clinics that could reach patients further away who previously had difficulty accessing their care. Or perhaps it will allow them to hire additional providers who can help see more patients. We don’t know.

I like to look at the costs for the patient and the costs for the insurer. And especially given what’s been found in other areas, see if costs go up, which has happened in several other areas of medicine.

And the main thing I would look at, if budget were not a constraint, is patient outcomes. Patients undergoing IVF care hope to have a baby – in the hope of building their family – which is a very powerful and very important outcome that they are looking for. It is very important to know: do these improve results?

What should patients consider when deciding where to go for fertility care based on your research results?

It is important that they look for clinics that are members of the Association for Assisted Reproductive Technology. Many of those clinics are focused on quality improvement. I would encourage patients to look for clinics that have experience with IVF.

[And] this is more about the actual providers than the clinic in general, but that [patients] ultimately end up with a provider where they feel like they are a good fit and with whom they can build trust.

Going through IVF is really difficult. It’s hard financially, emotionally, physically. It is not necessarily an easy treatment for patients. The connection between the patient and his healthcare provider is very important.