News | Investment in fertility care: better quality or concerns over costs?
A new study published in the Journal of the American Medical Association (JAMA) shows that private equity is rapidly reshaping fertility care in the United States and has become a major force among in vitro fertilization (IVF) providers. By 2023, more than half of U.S. IVF cycles took place at fertility clinics affiliated with private equity firms.
The study was led by James Dupree, professor of urology and obstetrics and gynecology at the University of Michigan Medical School. Dupree also directs the male fertility preservation program at Michigan Medicine and has long studied the accessibility and quality of fertility care. He said private investment in healthcare has accelerated markedly over the past decade, with fertility care among its fastest-growing segments.
The team systematically analyzed nationwide IVF clinic data that the Centers for Disease Control and Prevention (CDC) is legally required to collect. Under federal law, all U.S. fertility clinics must report IVF cycle information to the CDC. Researchers used official data from 2013 to 2022, together with public databases and online searches, to identify clinics owned by or invested in by private equity firms.
The change was striking: only about 4% of U.S. fertility clinics were affiliated with private equity in 2013, rising to about 32% by 2023. More notably, these clinics performed over half of all IVF cycles nationwide.
"By volume, private equity-backed clinics have become core providers of IVF services in the United States," Dupree said.
The effect on patients remains difficult to characterize. Dupree noted that modernizing IVF laboratories, continually investing in embryo culture and cryopreservation technology, and expanding patient education and services all require substantial funding, which private equity can provide. "This model may help improve medical equipment and some aspects of service quality."
However, he stressed that research in other areas of healthcare suggests private equity involvement may be accompanied by higher costs and lower quality. "In fertility care, we still cannot determine whether this produces a net benefit or a potential loss for patients."
In the United States, a single IVF cycle typically costs thousands of dollars and is often not covered by private or public insurance. The effect of private equity on clinic operations, pricing, and affordability is therefore drawing close attention from researchers and policymakers.
Dupree said that as the federal government signals plans to expand access to IVF, private equity-backed fertility care will become an unavoidable focus of research and regulation. "Because this business model is now so widespread, we must systematically assess its risks and benefits—including whether quality, costs, and equitable access to treatment have improved or worsened."
The team plans to examine whether private equity-backed fertility clinics differ systematically in success rates, fees, patient experience, and insurance coverage, providing evidence for future reproductive health policy.
The study's first author was Jesper Ke, a resident at Yale School of Medicine. Other authors included University of Michigan medical student Joshua Chen, statistician Elena Chun, and urology professor Vahakn Shahinian. The study was funded by the University of Michigan Institute for Healthcare Policy and Innovation.
News | Investment in fertility care: better quality or concerns over costs?
News | Investment in fertility care: better quality or concerns over costs?
A new study published in the Journal of the American Medical Association (JAMA) shows that private equity is rapidly reshaping fertility care in the United States and has become a major force among in vitro fertilization (IVF) providers. By 2023, more than half of U.S. IVF cycles took place at fertility clinics affiliated with private equity firms.
The study was led by James Dupree, professor of urology and obstetrics and gynecology at the University of Michigan Medical School. Dupree also directs the male fertility preservation program at Michigan Medicine and has long studied the accessibility and quality of fertility care. He said private investment in healthcare has accelerated markedly over the past decade, with fertility care among its fastest-growing segments.
The team systematically analyzed nationwide IVF clinic data that the Centers for Disease Control and Prevention (CDC) is legally required to collect. Under federal law, all U.S. fertility clinics must report IVF cycle information to the CDC. Researchers used official data from 2013 to 2022, together with public databases and online searches, to identify clinics owned by or invested in by private equity firms.
The change was striking: only about 4% of U.S. fertility clinics were affiliated with private equity in 2013, rising to about 32% by 2023. More notably, these clinics performed over half of all IVF cycles nationwide.
"By volume, private equity-backed clinics have become core providers of IVF services in the United States," Dupree said.
The effect on patients remains difficult to characterize. Dupree noted that modernizing IVF laboratories, continually investing in embryo culture and cryopreservation technology, and expanding patient education and services all require substantial funding, which private equity can provide. "This model may help improve medical equipment and some aspects of service quality."
However, he stressed that research in other areas of healthcare suggests private equity involvement may be accompanied by higher costs and lower quality. "In fertility care, we still cannot determine whether this produces a net benefit or a potential loss for patients."
In the United States, a single IVF cycle typically costs thousands of dollars and is often not covered by private or public insurance. The effect of private equity on clinic operations, pricing, and affordability is therefore drawing close attention from researchers and policymakers.
Dupree said that as the federal government signals plans to expand access to IVF, private equity-backed fertility care will become an unavoidable focus of research and regulation. "Because this business model is now so widespread, we must systematically assess its risks and benefits—including whether quality, costs, and equitable access to treatment have improved or worsened."
The team plans to examine whether private equity-backed fertility clinics differ systematically in success rates, fees, patient experience, and insurance coverage, providing evidence for future reproductive health policy.
The study's first author was Jesper Ke, a resident at Yale School of Medicine. Other authors included University of Michigan medical student Joshua Chen, statistician Elena Chun, and urology professor Vahakn Shahinian. The study was funded by the University of Michigan Institute for Healthcare Policy and Innovation.
Story source:
Collected online