Private investors continue gaining control of fertility clinics nationwide.
Private equity firms continue to gain ground in the fertility care industry, despite state laws designed to keep corporate control out of medical practice. A new review of national data shows that legal safeguards intended to protect the independence of fertility clinics appear to have little to no effect on whether those clinics become tied to private investors.
The analysis, presented at the American Society for Reproductive Medicine’s annual meeting, looked at data from hundreds of fertility clinics across the United States between 2011 and 2022. During that time, 180 of the 640 clinics that performed in vitro fertilization were found to be affiliated with private equity firms. The number of such affiliations has steadily increased in recent years, reflecting a trend seen in other parts of healthcare.
Lead researcher Joshua Chen, a medical student at the University of Michigan, examined whether existing state laws made any difference. Thirty-three states and Washington, D.C. have corporate practice of medicine laws, which prevent non-physician businesses from owning or controlling medical practices. Six of those states—Washington, Oregon, Nevada, New York, Massachusetts, and Connecticut—also require healthcare companies to notify or seek approval from the attorney general when making large transactions.
Chen and his team compared these legal protections with data on clinic ownership but found no connection. Whether a clinic operated in a state with strong restrictions or without them, the odds of private equity involvement were about the same. This suggests that the current laws are not effectively preventing outside investors from entering the fertility space.
Chen said that if policymakers truly want to control corporate influence in reproductive medicine, new and more targeted laws will be needed. He pointed to Oregon’s recently enacted Senate Bill 951 as a possible model. The law blocks management companies—often used by private equity to run medical businesses—from exerting control over clinical decisions. According to Chen, this approach directly addresses the tactics that investors use to bypass ownership restrictions.
Fertility specialists say that private equity’s growing presence brings both opportunities and risks. Dr. Rachel Weinerman, a reproductive endocrinologist at Case Western Reserve University, said many clinics are being absorbed into larger networks backed by private investors. These mergers often promise greater efficiency and access to care, but she warned that they can also shift priorities away from patient needs.
Weinerman said that once profit becomes a driving force, physicians may feel subtle pressure to promote higher-cost procedures like IVF, even when simpler treatments might be appropriate. She explained that doctors are trained to do what’s best for their patients, but financial incentives can make that harder when employers expect specific performance outcomes or revenue goals.
The research team gathered their data from the CDC’s Assisted Reproductive Technology reports, which track IVF success rates across the country. They then cross-checked each clinic against merger and acquisition databases, along with online searches to identify private equity ownership. The results showed a clear upward trend in investment activity over the past decade, regardless of state regulation.
Chen acknowledged that his study had some limits. Not all clinic transactions are made public, and not every clinic reports to the CDC. The laws themselves also vary in how strictly they are enforced, making it difficult to measure their true impact. Still, the findings raise concerns that the existing legal framework may not be keeping pace with how aggressively investors are moving into medicine.
Critics of private equity say that investors often prioritize financial returns over long-term patient care. They warn that consolidation could reduce competition, limit patient options, and erode trust between doctors and patients. Supporters, however, argue that outside funding helps clinics modernize, expand, and serve more people seeking fertility treatment.
The debate over corporate involvement in healthcare is not new, but the rapid expansion of private equity in fertility medicine makes it more pressing. As the cost of IVF continues to rise and more couples turn to assisted reproduction, ownership and control of these clinics will likely remain under scrutiny. For now, the evidence suggests that current state laws are failing to hold back corporate expansion in this sensitive area of care, leaving lawmakers to decide what comes next.
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Private Equity Tightens Grip on Fertility Clinics Despite State Laws
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