Private equity firms have seen a significant increase in their involvement with fertility clinics across the United States over the past decade, according to new research published in JAMA. The study, led by James Dupree, M.D., M.P.H., professor at the University of Michigan Medical School and director of U-M Health's Male Fertility Preservation Program, analyzed trends from 2013 to 2022 using federal data from the Centers for Disease Control and Prevention.
The researchers found that private equity affiliations among fertility clinics have grown sharply. In 2013, only 4% of such clinics were connected to private equity firms. By 2023, this figure had risen to an estimated 32%. Furthermore, these affiliated clinics performed more than half of all in vitro fertilization (IVF) cycles nationwide last year.
"As of 2023, we estimate that 32% of IVF clinics were affiliated with private equity firms," said Dupree. "And these clinics affiliated with these private equity firms are performing over half of the IVF cycles in the country."
Dupree noted that while private equity investment could provide necessary capital for modernizing equipment and expanding patient outreach—potentially improving quality and care—there are also concerns based on experiences in other health care sectors where such investments have sometimes led to higher costs and lower quality.
"There's a lot we don't know yet. It might be good for patients; it costs a lot of money to modernize IVF laboratory equipment and perform outreach to patients and private equity firms can provide capital to hopefully improve quality and patient care."
He added: "We don't know yet in the fertility world whether this is a net gain for patients or net loss."
Dupree emphasized the importance of continued research into how this business model affects key factors like quality, cost, and access to care. He stated: "Given how prevalent the business model is, we need to do more research and understand the benefits and risks - like the quality of care, cost of care, access to care - are they better or are they worse?"
The study was conducted by Jesper Ke, M.D., MBA (Yale School of Medicine), Joshua Chen (U-M medical student), Elena Chun, M.S. (U-M statistician), Vahakn Shahinian, M.D. (U-M urology professor), along with Dupree. Both Dupree and Shahinian are members of the U-M Institute for Healthcare Policy and Innovation, which supported this research through its Policy Sprints program.
The findings come as government interest grows in making IVF services more accessible nationwide.
As part of ongoing efforts to inform future health policies related to infertility treatment coverage by insurance companies and overall patient outcomes, Dupree’s team plans further studies on fertility care trends across the country.
