Private Equity Firms Now Control More Than Half of All IVF Cycles in the United States
Private equity firms have quietly but rapidly become one of the most influential forces in American fertility care. A new study published in the Journal of the American Medical Association (JAMA) reveals that private equity–affiliated clinics now oversee more than half of all IVF cycles performed in the United States, marking a major shift in how reproductive healthcare is delivered.
This change did not happen overnight. Over the past decade, private equity investment in healthcare facilities has expanded at a striking pace, and fertility care has emerged as one of its most active areas. IVF, or in vitro fertilization, is an especially attractive sector because it is expensive, highly specialized, and often paid for directly by patients rather than insurance companies.
How Private Equity Entered the Fertility Space
IVF treatments can cost thousands to tens of thousands of dollars per cycle, and most insurance plans in the U.S. do not fully cover infertility treatments. This has created a market where clinics rely heavily on patient payments, making fertility care financially appealing to investors.
Researchers led by Dr. James Dupree, a professor of urology and obstetrics and gynecology at the University of Michigan Medical School, wanted to understand how deeply private equity firms have become embedded in this space. Dr. Dupree also directs the Male Fertility Preservation Program at U-M Health and has long studied fertility care systems.
The research team analyzed national data to track how fertility clinics have changed ownership and affiliations over time. What they found was a dramatic transformation.
The Data Behind the Findings
Under U.S. federal law, every fertility clinic is required to report detailed information about its IVF cycles to the Centers for Disease Control and Prevention (CDC). These reports include the number of cycles performed each year and form one of the most comprehensive datasets on fertility care in the country.
Using CDC data from 2013 to 2022, the researchers examined every IVF clinic in the United States, including both private practices and hospital-based programs. They then combined this information with external databases and extensive online research to identify which clinics were affiliated with private equity firms.
The results show a clear and rapid rise in private equity involvement.
- In 2013, only 4% of fertility clinics in the U.S. were affiliated with private equity firms.
- By 2023, that number had increased to an estimated 32% of all IVF clinics.
- Most strikingly, those private equity–affiliated clinics accounted for over 50% of all IVF cycles performed nationwide in 2023.
This means that while private equity firms do not yet own a majority of fertility clinics by number, they control clinics that perform a disproportionately large share of IVF treatments.
Why Private Equity Clinics Perform So Many IVF Cycles
One reason private equity–affiliated clinics dominate IVF volume is scale. These firms often acquire large, high-volume practices or merge multiple clinics into regional or national networks. This allows them to centralize administrative operations, invest in marketing, and expand patient outreach.
Modern IVF labs require expensive, constantly updated equipment, and private equity firms can provide the capital needed to upgrade facilities and expand services. Supporters argue this investment could improve efficiency, increase access, and potentially enhance patient experience.
However, the long-term impact of this business model remains unclear.
What This Could Mean for Patients
The study does not claim that private equity involvement is inherently good or bad for fertility patients. Instead, it highlights how little is currently known about the consequences.
In other areas of healthcare, research has suggested that private equity ownership can sometimes lead to higher costs for patients and declines in certain quality measures. Whether the same patterns apply to fertility care is still an open question.
Dr. Dupree and his colleagues emphasize that fertility care is unique. IVF outcomes depend on complex laboratory processes, physician expertise, and individualized treatment decisions. Introducing strong financial incentives into this environment could influence how care is delivered, but the direction of that influence is not yet fully understood.
Fertility Care and Government Interest in IVF Access
The findings arrive at a time when the U.S. government has shown renewed interest in expanding access to IVF for people with infertility. Policymakers are increasingly debating insurance mandates, employer coverage, and public funding options.
Given that private equity firms now play such a large role in fertility care delivery, understanding how this ownership structure affects cost, quality, and access is becoming more urgent. Any future policy aimed at expanding IVF access will need to account for the reality that much of this care is delivered by investor-backed organizations.
Who Conducted the Study
The study’s first author is Dr. Jesper Ke, a resident physician at Yale School of Medicine. Dr. Ke earned his medical degree from the University of Michigan Medical School and an MBA from the Ross School of Business, completing his education in 2025.
Other contributors include:
- Joshua Chen, a University of Michigan medical student
- Elena Chun, M.S., a statistician at the University of Michigan
- Dr. Vahakn Shahinian, a professor of urology at the University of Michigan
Together, the team brings expertise from medicine, business, and data analysis, reflecting the multidisciplinary nature of modern healthcare research.
Understanding IVF in the U.S. Healthcare System
IVF has become an increasingly common treatment for infertility, which affects millions of individuals and couples in the United States. Despite its prevalence, IVF remains unevenly accessible, largely due to its cost and inconsistent insurance coverage.
Only a limited number of states require insurers to cover fertility treatments, and even in those states, coverage can vary widely. As a result, many patients delay treatment, take on significant debt, or abandon IVF altogether.
This financial pressure is one reason the fertility industry has been attractive to private equity. Clinics that can streamline operations, expand patient volume, and standardize care may generate strong financial returns.
What Comes Next for Fertility Care Research
The authors of the JAMA study stress that this is only a starting point. Future research will need to examine whether private equity–affiliated clinics differ from independent clinics in terms of:
- IVF success rates
- Patient safety and complications
- Treatment costs and pricing transparency
- Access for lower-income or rural patients
Dr. Dupree and his team plan to continue studying fertility care across the United States, including how insurance coverage and ownership models shape patient outcomes.
As private equity becomes a dominant force in IVF, understanding its impact will be critical—not just for patients, but for doctors, policymakers, and anyone concerned about the future of reproductive healthcare.
Research Reference:
https://jamanetwork.com/journals/jama/fullarticle/2843295
