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State of Play
In the last decade, private equity firms have moved swiftly to consolidate the fertility clinic industry—across the U.S., Europe, and parts of Asia.
By 2018, nearly 30% of all assisted reproductive technology (ART) cycles in the U.S. were performed by clinics affiliated with private equity platforms. Today, that share is even higher.
And while the headlines around PE in healthcare often skew negative—citing stories of over-levered hospital groups and underfunded staffing—a 2023 academic study from professors at UC Berkeley and Copenhagen Business School painted a more nuanced picture for fertility clinics. Their findings? IVF success rates increased by 13.6% following a clinic’s acquisition by a fertility platform.
Let’s unpack what’s driving private equity interest in this space—and how firms are building scale.
Investment Thesis
Private equity interest in fertility clinics is grounded in both demographic tailwinds and attractive business fundamentals.
📈 1. Favorable Demographic Trends
More people are delaying parenthood, and infertility rates are rising. In 2023, 1 in 5 U.S. women ages 15–49 experienced difficulty conceiving after a year of trying. Roughly 1 in 4 had trouble carrying a pregnancy to term.
A key driver is the rising average maternal age—making fertility support a more common (and often necessary) part of the journey to parenthood.
Source: Northwell Health
Source: BDA Partners
✨ 2. Rising Adoption via Tech + Insurance
Advances in reproductive medicine have made IVF more effective, while expanding insurance coverage has made it more accessible.
According to Global Health Economics & Sustainability, the live birth rate per IVF cycle for younger patients has climbed from 25–30% in 2000 to 35–45% by 2020.
At the same time, policy shifts have unlocked access:
21 U.S. states now mandate some form of fertility coverage (vs. just 8 in 2005)
Large employers are adding fertility benefits (IVF, egg freezing, surrogacy) to compete for talent
For patients, this means more people can now afford treatments that previously cost $15,000+ per cycle
Source: Axios
Source: BDA Partners
🧩 3. Large and Growing Industry
With demand rising and technology improving, the U.S. fertility services market has grown rapidly—reaching $6 billion in size, according to Precedent Research.
Source: Precedent Research
⚖️ 4. Attractive Financial Profile
From a private equity standpoint, fertility clinics check several key boxes:
High customer LTV: The average cost of a single IVF cycle ranges from $12,000 to $20,000 in the U.S. (excluding medications), and many patients undergo multiple cycles – yielding high revenue from each one of the customers
High margins: according to BDA Partners, fertility clinic platforms generate ~33% EBITDA margins
Cash pay: Historically, more than half of fertility spend has been out-of-pocket
Limited government reimbursement risk: Unlike other healthcare verticals, fertility clinics aren’t exposed to Medicare/Medicaid pricing pressure. Most revenue comes from private insurance or employer-sponsored plans.
PE-Backed Platforms
Over the last decade, several PE-backed platforms have popped up across the globe. Some notable U.S./Europe platforms include:
Platform | PE Firm(s) | Invested | Geography |
|---|---|---|---|
FutureLife | Hartenberg / CVC | 2013 / 2021 | Europe |
CCRM | TA Associates / Altas / Ares | 2015 / 2021 | U.S. |
Inception Fertility | Lee Equity / Waypoint | 2016 / 2019 | U.S. |
Pinnacle Fertility | Webster Equity Partners | 2019 | U.S. |
US Fertility | Amulet Capital Partners | 2020 | U.S. |
IVIRMA Global | KKR | 2022 | Global |
Quick Case Study: US Fertility
Among the platforms above, US Fertility (USF) stands out as a textbook example of rapid consolidation through private equity ownership.
Launched in 2020, USF was created by Amulet Capital Partners in partnership with Shady Grove Fertility—one of the largest and most well-established IVF providers in the country. Shady Grove already operated 50+ clinics across major states like Maryland, Texas, California, and New York.
From there, USF scaled quickly:
Acquired IntegraMed’s software business to anchor its MSO model
Rolled up other leading clinics: Fertility Center of Illinois, Reproductive Science Center of the SF Bay Area, IVF Florida
By late 2020: ~55 locations, 80 physicians
Then came a burst of larger M&A moves:
2023: Acquired Ovation Fertility (backed by Morgan Stanley Capital Partners) → reaching 90+ clinics
Later 2023: Acquired Reproductive Medicine Associates of NY → scaling to 130+ clinics
Today, USF is the largest fertility platform in the U.S.
200+ physicians
105+ clinics
32 IVF labs
30,000+ IVF cycles per year
225,000+ patients served
US Fertility is a good case study of how fertility clinics in the U.S. consolidated rapidly under various PE-backed platforms.
Looking Ahead
According to Fertility Bridge, half of all U.S. states now have three or fewer independent fertility practices. In 12 states, there’s just one.
Despite that level of consolidation, PE interest remains high. Valuations for scaled platforms are reportedly trading at 20x+ EBITDA, reflecting the strength of the sector.
Source: BDA Partners
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