Private equity firms are increasingly dominating fertility clinics in the United States

Private equity firms are increasingly dominating fertility clinics in the United States

The rise of private equity firms investing in healthcare facilities across the United States has exploded over the past decade.

Because of this rapid growth, researchers have been studying what this could mean for healthcare and patients in the long term.

In recent years, private equity firms have become more active in the fertility space, where many patients seek treatment for reproductive problems and undergo in vitro fertilization, or IVF, which costs thousands of dollars and is typically not covered by insurance.

James Dupree, MD, MPH, and colleagues wanted to investigate what these changes might mean for patients with infertility. Dupree is a professor of urology, obstetrics and gynecology at the University of Michigan Medical School, directs UM Health's Male Fertility Preservation Program and studies fertility care.

In their new article published inJAMAThe team shows that since 2013 there has been an expansive growth in connections between fertility clinics and private equity firms.

They also note that in 2023, more than half of IVF cycles in the country were performed at clinics affiliated with private equity firms.

More about paper

A federal law requires every fertility clinic to report data about their IVF cycles to the federal Centers for Disease Control and Prevention.

The team used these reports from 2013 to 2022 to examine every IVF clinic in the country, including private practices and hospital-based clinics.

They used other databases and online searches to find out which clinics were affiliated with private equity firms.

What they found was pretty dramatic growth. In 2013, only 4% of fertility clinics were affiliated with private equity firms. But since then the number has exploded.

We estimate that in 2023, 32% of IVF clinics were affiliated with private equity firms. And these clinics affiliated with these private equity firms perform over half of the IVF cycles in the country.”

James Dupree, MD, MPH, Professor of Urology, Obstetrics and Gynecology, University of Michigan Medical School

So what does that mean?

"There's a lot we don't know yet. It could be good for patients; upgrading IVF lab equipment and connecting with patients costs a lot of money, and private equity firms can provide capital to hopefully improve quality and patient care."

He also explains that in other healthcare settings outside of fertility care, there is data to suggest that quality may be declining while costs are rising.

“We don’t yet know in the fertility world whether this is a net gain for patients or a net loss,” he said.

Dupree emphasizes that private equity-backed fertility care will be a critical business model to further explore, especially given the government's recent interest in making IVF treatment more accessible to Americans with infertility.

He said: "Given the prevalence of the business model, we need to do more research and understand the benefits and risks - such as the quality of care, the cost of care, access to care - are they better or worse?"

As top researchers in the field, Dupree and his team will continue his work addressing fertility care in the United States, including how IVF is covered by insurance companies, to hopefully help inform future healthcare policies and help patients in the long term.

The study's lead author, Jesper Ke, MD, MBA, is a resident at Yale School of Medicine and graduated from UM Medical School and the Ross School of Business in 2025. Additional authors include UM medical student Joshua Chen, UM statistician Elena Chun, MS, and UM urology professor Vahakn Shahinian, MD

Dupree and Shaninian are members of the UM Institute for Healthcare Policy and Innovation, which supported the research through a grant from its Policy Sprints program.

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