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2024 Fertility Practice List: Who Owns America’s IVF Clinics?

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Consolidation Dominates the Fertility Market as Independent Practices Dwindle

This News Digest Story is paid featured content. The advertiser has had editorial input and control over its creation. However, the views and opinions expressed in this article do not necessarily represent the views of Inside Reproductive Health. The sponsorship of this content does not imply an endorsement by Inside Reproductive Health.

This News Digest is Paid Sponsored Content From

 
 

BY INSIDE REPRODUCTIVE HEALTH

The 2024 U.S. Fertility Practice Ownership List compiled by Inside Reproductive Health and sponsored by MidCap Advisors,  is a comprehensive report detailing the ownership structures of 467 fertility practices across the U.S.

It categorizes each practice as Independent, Academic/Health System, or part of a Fertility Clinic Network, offering insights into market consolidation trends and private equity involvement. The list was compiled using data from fertility clinic websites, CDC reports, and independent expert reviews, providing an up-to-date view of the fertility industry's evolving landscape.  

The findings in this report are particularly timely, as they capture a market in flux, where independent practices are becoming less common, and fertility clinic networks, often backed by private equity, dominate the landscape.

Key Findings: Consolidation and Fragmentation

Two major trends outlined in the report highlight critical developments shaping the current landscape of the fertility industry:

  1. Substantial Market Consolidation: Scott Yoder, Managing Director at MidCap Advisors notes that “There has been substantial consolidation over the past five years, with US Fertility capturing a significant market share compared to the other consolidators through their substantial Shady Grove and Ovation transactions.” This trend highlights the dominance of a few major players, particularly US Fertility, which has emerged as a market leader through larger strategic acquisitions.

  2. Shrinking Independent Practice Market: The Fertility practice market is becoming less fragmented, with the remaining independents being smaller clinics scattered across the country. The list indicates that 50% of U.S. states now have three or fewer independent fertility practices, with 12 states having just one independent clinic.

FREE Practice Ownership List

Who Owns Each Fertility Clinic In the U.S.? Discover the Ownership Status of 450+ Fertility Practices

  • Get a comprehensive list of every fertility clinic in the USA. Updated October 2024

  • Find out if they are:

    • Independently owned

    • Part of a fertility clinic network

    • Affiliated with an academic/health system

  • Stay informed about consolidation trends in the fertility industry

  • Perfect for independent practice owners and industry professionals--see who is still independent!

Download it now for free – just fill out a short form on the next page and get instant access.

Consolidation: Historical Trends and Future Outlook

Robert Goodman, VP of Healthcare at MidCap Advisors, “The peak of fertility mergers and acquisitions (M&A) occurred in 2021, driven by favorable economic conditions and aggressive acquisition strategies.” However, the market has since cooled slightly due to financial headwinds, the lower number of larger practices, and the increased complexity of deal-making.

Yoder explains, “As consistent with any industry consolidation, size matters. The fertility market was no exception. The practices with larger REI groups were pursued and acquired first. What typically remains are independent practices with 1 to 4 REIs, with a significant tilt toward the lower end of that range.” This reflects a clear preference for larger, multi-physician practices by investors, leaving behind a fragmented market of smaller independent clinics.

Looking forward, the fertility M&A deal count will trend down due to the limited REI fragmentation that remains. “Approximately 50% are single REI practices which buyers typically have no appetite for due to continuity risk and the smaller deal size. Although there may be a lower projected deal count, there will still be steady M&A deal activity that will be fueled by the aging REI ownership, the falling interest rates, the sizable dry powder still looking to be deployed by private equity, and transactions among the larger players” notes Yoder.  

Additional Key Observations

Several other important trends also emerge from the list:

  • Geographic Concentration: Six states—California, New York, Texas, Florida, New Jersey, and Illinois—account for 56% of the remaining independent fertility practices. This concentration in larger, more populous states reflects the increasing geographic focus of consolidation efforts, as private equity investors and networks seek to capture market share in high-demand regions.

  • M&A Activity Slowing: Although M&A activity in the fertility sector remains strong, it is down approximately 25% from its 2021 peak. Nonetheless, current deal counts are still 70% higher than pre-2021 levels, reflecting continued investor interest in the sector..

  • State of Independent Practices: The list indicates that single-REI practices represent a significant portion of the remaining independent market. These smaller operations may find it increasingly difficult to remain competitive unless they consider partnerships or mergers with similar-sized practices, positioning themselves for future growth or acquisition.

List Published, Available Now

The 2024 U.S. Fertility Practice Ownership List is now available, offering the most up-to-date and comprehensive snapshot of fertility practice ownership across the U.S., and answers how many and which of them remain independent

FREE Practice Ownership List

Who Owns Each Fertility Clinic In the U.S.? Discover the Ownership Status of 450+ Fertility Practices

  • Get a comprehensive list of every fertility clinic in the USA. Updated October 2024

  • Find out if they are:

    • Independently owned

    • Part of a fertility clinic network

    • Affiliated with an academic/health system

  • Stay informed about consolidation trends in the fertility industry

  • Perfect for independent practice owners and industry professionals--see who is still independent!

Download it now for free – just fill out a short form on the next page and get instant access.

This News Digest is Paid Sponsored Content From

 
 

All external links active as of 10/10/2024

External links are being provided as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by Fertility Bridge or Inside Reproductive Health of any of the products, services or opinions of the corporation or organization or individual. Neither Fertility Bridge nor Inside Reproductive Health bears responsibility for the accuracy, legality or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.

 
 
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$20M. Arredondo, Pozitivf's plans for affordable IVF expansion in Texas

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THREE NEW CLINICS PLANNED IN 3-4 YEARS

The content and themes expressed within the article are that of the news. The advertiser does not have editorial control over the content of this article, and Inside Reproductive Health maintains full editorial independence. The views and opinions expressed in this article do not represent the views of the Advertiser or of Inside Reproductive Health.

 

BY MALLIKA MITRA

In an effort to make IVF more accessible, fertility clinic network Pozitivf says it will use $20 million it recently secured in funding led by MonCap to develop three new sites, build a training academy and improve its current systems.

Pozitivf, founded in late 2022, currently has one clinic and IVF lab in an 8,000-square space in San Antonio, Texas in addition to a satellite office in Brownsville, Texas. In 2023, they conducted roughly 350 IVF cycles, but the new funding will give them the ability to expand, according to Dr. Francisco Arredondo, Pozitivf's co-founder & CEO. The goal is to open three new clinics during the next three to four years within the “Texas Triangle,” a region made up of the state’s major cities —  San Antonio, Austin, Dallas-Fort Worth and Houston — that is home to nearly 70% of Texas’ population.

The company is also using the funds to address a major problem facing the fertility industry: a shortage of human capital. The team at Pozitivf created the andrology, embryology and nursing training program, IVF Academy USA, and has trained approximately four embryologists and andrologists every three to four months since June 2022 as well as three OBGYNs. Next year, it plans to train around 10 nurses, 10 nurse practitioners and 10 physician assistants. With the new funding, Pozitivf is building the physical academy in the 7,000-square feet below the clinic.

ORGANON IS COMMITTED TO HELPING ASPIRING PARENTS ON THEIR FERTILITY JOURNEY

Organon is proud to collaborate with the fertility community in championing care equity around the world and is committed to:

  • Elevating fertility education and awareness

  • Expanding resources and access to care

  • Investing in innovative fertility solutions

Every journey to parenthood is unique, and Organon is here to empower aspiring parents every step of the way.

 
 

“The idea is not to replace REIs with these other providers but to increase the capacity to make IVF more accessible geographically and financially,” Arredondo said.

Pozitivf is currently researching how to reduce variability and assessing what services do not add value. They say some add on tests haven’t been proven to be effective and some expensive filtering systems have not been proven by randomized controlled trials. The aim is to eliminate wasted inventory and inefficiency in their supply chain, Arredonodo said.

Focusing on long-term growth

Arredondo has expressed doubts about private equity’s role in medicine in the past. He said many firms are “obsessed with growth,” acquisitions and eliminating costs. That approach doesn’t work with the fertility industry, which is in its very early stages and only servicing around 20% of the women in the country who need IVF, he said. The cost of IVF continues to rise because a few companies dominate the market and there is a human capital shortage, so consolidation by private equity is not reducing costs, Arredondo added.

But MonCap is a venture capital firm whose investment strategy focuses on scalability, Arredondo said.

“One of the alignments that we had with MonCap was that we would not replicate things until we feel very confident that the processes have been documented… instead of replicating things that are not at an optimum place,” Arredondo said.

The $20 million funding round came amid a challenging time for raising capital, with venture funding falling in 2023 to its lowest level since 2017, according to research from market intelligence platform CB Insights. Moncap is also a primary investor of EngagedMD, which provides an admin software platform for caregivers in the fertility space.

Moncap’s managing partner, Jonathan Sockol, declined to comment on the firm’s investment strategy in the fertility sector at this time.

The content and themes expressed within the article are that of the news. The advertiser does not have editorial control over the content of this article, and Inside Reproductive Health maintains full editorial independence. The views and opinions expressed in this article do not represent the views of the Advertiser or of Inside Reproductive Health.

All external links active as of 6/13/2024

External links are being provided as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by Fertility Bridge or Inside Reproductive Health of any of the products, services or opinions of the corporation or organization or individual. Neither Fertility Bridge nor Inside Reproductive Health bears responsibility for the accuracy, legality or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.

 
 
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Recharge Capital Launches $200M Investment Vehicle to Streamline Fertility Services, Women’s Health

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Aims to Consolidate IVF Service Verticals by Continent, Starting with Southeast Asia

This News Digest BROUGHT TO YOU BY
THE FDA CONSULTANTS, LLC

 
 

BY: RON SHINKMAN

In an attempt at consolidating a fragmented global market for reproductive medical services, Recharge Capital has launched a $200 million vehicle to invest in women’s health, including IVF.

New York and Singapore-based Recharge Capital announced last month that the new holding company – called the Women’s Healthcare Investment Vehicle – will “be strategically deployed to invest, roll up, and create an end-to-end ecosystem within the women's fertility value chain across Southeast Asia, Latin America, Europe, and the Middle East.”

Recharge, which has assets of about $6 billion, has placed funds in “thematic-focused” investments. Along with women’s healthcare, these include clean biotech, semiconductors and fintech, among others.

The vehicle has at least eight big investors attached. Among them are Thiel Capital, run by billionaire Peter Thiel; the Al Rashid Family, headed by Saudi billionaire Nasser Ibrahim Al-Rashid; and Shamrock Holdings, the investing company for the estate of Roy Disney and members of the Disney family.

Lorin Gu, the 30-year-old founding partner of Recharge Capital, said in an email that “we aim to transform the sector by creating full-scale integration of disruptive technologies, diagnostic solutions, and seamless patient experiences through digital platforms and local clinic chains.”

One of the biggest issues causing fragmentation of reproductive medical services, according to Gu: Different laws and regulations by country.

“For example, many couples start their experience in China for consultation, believing that China has the best medical quality, but only to realize that the country has many restrictions such as egg freezing requirements, genetic testings and sex selection, which are allowed in other markets like Thailand and Malaysia,” Gu said. 

Generation Prime Planned to Launch 15 Clinics

Partly as a result, Gu predicts that about 70% of its customers in Asia will be Chinese medical tourists seeking services in other countries. “We want to demonstrate how a streamlined service can bring much more efficiency and less opacity to the process as patients navigate across different jurisdictions,” he said. 

One of the first ventures invested in by the Women’s Healthcare Investment Vehicle is Generation Prime, which received seed backing. It has plans to open 15 clinics in Thailand, Malaysia and Singapore.

“For Chinese patients seeking services not currently available in their home country, Generation Prime provides hand-holding experience for patients, starting from virtual education and consultation to understand the customization needs of the IVF journey, and then travel and treatment arrangements for specific services in our clinics in Singapore, Malaysia, Thailand,” Gu said. He added that some clients may also elect to obtain some services in the U.S., such as surrogacy. 

Global Expansion of IVF

David Sable, M.D., a life sciences portfolio manager in New York City who also founded two separate reproductive technology firms, suggests entrepreneurs are beginning to see reproductive medicine in global as opposed to regional terms, and it’s clear there is a mismatch between demand and available services. Worldwide, he said there are about 3 million IVF cycles a year performed on between 1.5 million and 2 million people when repeat cycles are included. But based on his company’s research and making some assumptions about the market, Sable believes there is probably enough demand worldwide to perform 20 to 30 million cycles annually.

“If you really map out demand for it, it’s easily a half-trillion-dollar industry,” he said. “Right now, it’s disguised as a $20 billion-a-year niche industry. So, I’m not surprised that people who have a lot of money to invest are putting capital into it.”

Gu said that in addition to Asia, Latin America, Europe and the Middle East are also expected to see enormous demand for services in the coming years. As in Asia, it is expected that clients will engage in foreign travel in order to receive the services they specifically desire but may not be able to obtain in their home countries. “A primary focus will be placed on international fertility medical tourism,” he noted. 

“Novel” Structure for Accountability to Investors

The Women’s Healthcare Investment Vehicle also has what Recharge has described as a novel structure for investors, based on a “milestone-driven deployment schedule.” According to Gu, the milestones are connected to revenue numbers and earnings before interest, taxes, depreciation and amortization.

“Investors and managers have clear visibility into how capital is being deployed (as opposed to a blind pool with little visibility), as well as reduced risks for capital usage,” Gu said.

The themes reported in this publication are those of the news. They do not reflect the views of Inside Reproductive Health, nor of the Advertiser

FDA on “Monster Hunt” for IVF Labs in Violation

One west coast fertility center reports being inspected by the FDA eight times in the last year. 

Because the FDA halted inspections due to the pandemic in 2020 and 2021, they are now going after fertility centers at greater frequency than ever before.

The FDA Consultants protect fertility centers by doing a “Mock FDA inspection” but they have a waitlist, and priority will go to clinics in their second year post-inspection and/or already have a warning letter.

 
 
 
 

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FDA Consultants

 
 

All external links active as of 7/27/23.

External links are being provided as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by Fertility Bridge or Inside Reproductive Health of any of the products, services or opinions of the corporation or organization or individual. Neither Fertility Bridge nor Inside Reproductive Health bears responsibility for the accuracy, legality or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.

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Silicon Valley Bank’s Ties to The Fertility Sector

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BY: RON SHINKMAN

Silicon Valley Bank (SVB) played a role in providing financing to companies in the fertility business. However, the impact of its recent failure on the sector appears to be minimal for now.

The Santa Clara, Calif.-based SVB failed on March 10, after its heavy investments in U.S. bonds were sunk by rising interest rates and inflation, eventually triggering a liquidity crisis and then a run on deposits. Its holdings are currently being managed by the Federal Deposit Insurance Corp. 

FDIC has promised to make all depositors whole. And all lines of credit have been transferred to a stopgap facility called the Silicon Valley Bridge Bank, the FDIC said.  

The bank, which was founded in 1983, had extensive involvement with the biotech industry, which is at the core of providing in vitro fertilization and other fertility services. SVB was involved in more than 250 investments with biotech and healthcare firms, according to data from Crunchbase.

“Silicon Valley Bank was generally focused on the tech space. For the most part, the folks in (the fertility space) are not quite like that,” said Robert Goodman, vice president of healthcare at MidCap Advisors, a New York City-based investment banking firm focusing on companies with annual revenue up to $250 million. However, Goodman noted that SVB was involved with some of the companies offering an all-in-one platform of fertility services.

SVB’s biggest investment in a fertility firm, that Inside Reproductive Health found, occurred in August 2021, when it was part of a consortium providing $75 million in Series C funding to Carrot Fertility, the Menlo Park, Calif. firm that provides services to health plans, self-funded employers and other entities, including major firms such as Slack and Peloton. Executives from Carrot did not respond to requests seeking comment about their financial future.

The bank also played a role in financing Progyny, a New York-based firm that like Carrot also offers fertility benefits to employer groups and other entities. It had a line of credit with SVB that was at least $15 million, according to a February 2022 report by the Australian financial information service News Bites. A Progyny spokesperson declined to comment.

SVB also played a role in securing financing for Oma Fertility. Last June, SVB provided the firm $8.5 million in credit. The announcement of the financing coincided with the startup’s unveiling of Oma Sperm InSight, a service guide with artificial intelligence that assists embryologists in identifying “the most promising sperm cell to pair with an egg in IVF,” the company said at the time. Oma was founded in 2020.

Along with the debt facility, Oma has raised an additional $29 million in series A funding. Oma executives declined to comment about its relationship with SVB and how it might impact the sector.

For now, the demise of SVB appears to have left a minimal footprint on the fertility sector. Goodman noted that the platform companies such as Carrot and Progyny are “pretty strong” financially and were not overly reliant on lines of credit or other bank services to keep their operations going. 

Goodman also believes that SVB’s failure had virtually no impact on smaller practices offering financing services to patients. He added that patient finance is typically the realm of bigger financial institutions, such as Barclays Bank and Wells Fargo Bank, as well as credit card firms such as Visa.

“I’d be very surprised” if such financial services took a hit, Goodman said.

Executives from Oma Fertility declined to comment on the security of the company’s financial future.

The themes reported in this publication are those of the news. They do not reflect the views of Inside Reproductive Health, nor of the Advertiser

 
 

All external links active as of 3/23/23.

External links are being provided as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by Fertility Bridge or Inside Reproductive Health of any of the products, services or opinions of the corporation or organization or individual. Neither Fertility Bridge nor Inside Reproductive Health bears responsibility for the accuracy, legality or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.

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$189 Million. Five Fertility Companies Raised the Most Venture Capital in 2022, say two VCs

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This News Digest Brought to You by
BUNDL

 
 
 

BY:  ERIN FLYNN JAY

According to two venture capitalists in the women’s health space, the top five venture capital raises of 2022 for Assisted Reproductive Technology (ART) companies were:

  1. Maven Clinic – Series E at $90M

  2. Oma Fertility--Series A at $29M

  3. AiVF – Series A at $25M

  4. Gameto – Seed at $23M

  5. Alife – Series A at $22M

The analysis was offered by two different venture capitalists who do not work together and who both wished not to be named. The raises do not include other businesses that look at provide prenatal or post-natal care, menopause, or contraception.

Who was behind these venture capital fund raises and what are they using the money for?

In November 2022, Maven Clinic, the largest virtual clinic in women's and family health, announced it raised a $90 million Series E funding round. According to a Maven Clinic press release, this was led by General Catalyst, with participation from CVS Health Ventures, La Famiglia, and Intermountain Ventures, as well as existing investors Sequoia, Oak HC/FT, Icon Ventures, Dragoneer Investment Group, and Lux Capital. 

This brought Maven's total funding to $300 million.

Maven is using this new funding to continue to invest in personalization across its platform in both commercial and Medicaid populations. 

Oma Fertility raised $29M through Seed and Series A rounds led by JAZZ Venture Partners, Root Ventures, Mithril Capital, Global Asset Capital, and Free Solo Ventures in addition to a $8.5M debt facility led by Silicon Valley Bank according to their June 2022 press release. Oma Fertility also purchases fertility clinics and is building De Novo IVF centers. They are associated with Oma Sperm Insight and Oma Robotics.

In June 2022, AiVF®, developer of the first fully operational AI-based IVF software platform, announced in a company press release that it raised $25 million in a Series A round led by Insight Partners, a New York-based venture capital and private equity firm with participation from Adam Neumann’s Family Office, 166 2nd.

AiVF is using the funding to fuel adoption of the company’s AI platform, EMA™ in the United States and Europe, expand its work force and develop additional solutions to drive a new generation of digital fertility care.

AiVF did not respond to requests for comment on their expanded capacity to serve the US and European markets. 

In January 2022, Gameto, a biotechnology start-up solving the problem of accelerated ovarian aging to change the trajectory of women's health and equality, announced it raised a $20 million in Series A funding led by Future Ventures, with participation from Bold Capital Partners, Lux Capital, Plum Alley, TA Ventures, Overwater Ventures, Robert Nelsen and Anne Wojcicki. 

Gameto also raised $3 million in Seed funding in March 2020 from a range of notable investors including Jack Abraham, SALT Fund, FJ Labs, Dan Rose and Brian Armstrong, according to a company press release.

The Series A funding was led by venture-capital firm Future Ventures. Founded by Steve Jurvetson and Maryanna Saenko, Future Ventures focuses on early-stage disruptive technologies.

Gameto is building a platform for ovarian therapeutics to initially address menopause and improve assisted fertility with three sequenced programs:

  1. Fertilo. Treats oocytes outside of the body, increasing maturation rates and oocyte quality to improve IVF and egg freezing outcomes.

  2. Deovo. To initiate drug discovery and a computational platform for ovarian aging.

  3. Ameno. A cell-based therapeutic to disassociate the unwanted effects of menopause that occur with the loss of fertility.


In March 2022, Alife Health, the fertility technology company building artificial intelligence tools to advance in-vitro fertilization (IVF), announced it raised $22 million in Series A financing co-led by existing Seed lead Deena Shakir at Lux Capital, and new investors Rebecca Kaden at Union Square Ventures and Anarghya Vardhana at Maveron, both of whom joined Alife's Board of Directors.

With its new funding, Alife brought its first two products to market and continues conducting clinical studies for a third product. Alife's first medical product, Stim Assist, was released in October 2022. It is used during the ovarian stimulation process. 

Alife also released its first patient product late last year. Upon conducting extensive interviews with past IVF patients, Alife identified the need to streamline and organize the IVF process. With Alife's mobile app, patients gain a comprehensive platform that includes educational resources and easy-to-use organizational tools for medication reminders, appointments, lab results, and more.

"Looking into 2023, there is still a large amount of capital that funds must deploy in the near future, but I expect that they will be very selective on who they fund" remarks Dr. Eduardo Hariton, a practicing REI physician who is the Managing Director of US Fertility's Innovation Fund. "Companies who have not been able to achieve product-market fit or meet previous milestones may struggle to raise further capital. Ultimately, this may lead to some consolidation of companies in our space." 
 

The themes reported in this publication are those of the news. They do not reflect the views of Inside Reproductive Health, nor of the Advertiser

IVF Patient Drop Out Rises, Patients Seek Fertility Clinic

The number of patients who do not continue after a failed IVF cycle is on the rise at some IVF centers.

To counter the decrease in IVF revenue, fertility centers are turning to partners who have IVF-ready, financially qualified patients, but who don’t yet have a fertility clinic.

Courtney from BUNDL has a list of treatment-ready patients in each city. There is no fee but the offer is for the US and Canada only.

 
 

All external links active as of 2/9/23.

External links are being provided as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by Fertility Bridge or Inside Reproductive Health of any of the products, services or opinions of the corporation or organization or individual. Neither Fertility Bridge nor Inside Reproductive Health bears responsibility for the accuracy, legality or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.