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“Everyone in our class is freaking out right now…”
That’s the text I got from a fellow last year during the Park City retreat.
In this episode, I break down the state of fertility center networks in 2026, based on what I’m hearing directly from physicians, operators, and investors across the field.
This is not sponsored commentary, and none of the organizations mentioned had editorial control or preview access. This is my unfiltered read on what’s actually happening, and where things are headed.
We cover:
Why most large fertility networks are for sale (and why more consolidation is likely in 2026)
How the war for REI talent is driving valuation, strategy, and culture
Why groups of 5–10 physician-owned practices may be critical for innovation long-term
What younger doctors are actually optimizing for (Hint: it’s not just comp)
How burnout, autonomy, research, and safety are becoming competitive differentiators
The growing importance of embryology, lab automation, and patient safety infrastructure
Get an even deeper inside look at the current state of fertility networks from our recent Intel Article
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Griffin Jones (01:03)
Everyone's freaking out. That's the opening to the state of fertility center networks. 2026 article released by inside reproductive health, you're going to be getting these every quarter in one form or another either podcast episode, or news reports of what's going on in every vertical in the fertility space. And we start with fertility center networks, if you want to get in on this and have the opportunity to have some positive coverage and things that you want included about how you're impacting your vertical, become a sponsor of the IVF Heroes universe. It's super easy. But you should also know that none of the organizations or individuals mentioned in any of these category overviews have had any editorial control over its content. They don't get to review it. We do take some information and consider it from the Business Intelligence Hub, but nobody that I'm talking about, be they an individual or a company has had a chance to take a look at this. It's our reporting of what's going on in the space.
And then when it's a podcast episode, it's my commentary about just what I think, not me as a journalist or news editor, but as a commentator of what I'm speculating about and what I'm hearing. The reason why that quote started off is I got a text back last year when the Park City fellows retreat was going on, from a fellow I know saying we're in the process of signing with different practices. Everyone in our class is freaking out right now and asking me, is this group going to sell? What's that going to be like? And I said, yeah, they're going to sell. Almost all of them are going to sell. Almost all of them are for sale right now. And maybe that's a good thing, but it's something that people need to consider. And I think that younger docs are a little freaked out about it.
I don't think they should be universally freaked out about it. I some networks are doing things better than others. But I do think it's something they should consider. And I think that it's part of what's going on in terms of the war for talent, the race to be as efficient as possible and what seems to be like a renewed interest in independent practice.
When I say that these groups are selling the first domino to fall was US fertility they Acquired or 42.5 % stake of theirs was acquired by L. Katterton seems like their Existing private equity partner Amulet Capital Partners is staying in the game. So they're injecting new capital in and so the information on the
deal that Inside Reproductive Health got said that the physicians in management will keep 15 % ownership of the venture.
I suspect that with that money, you'll see US Fertility purchase some more practices. I think one deal is probably pending in the news. I think that the pause that we saw on the acquisition of private practices might resume and US Fertility uses some of this money to buy the last remaining
independent practices that still look really good to a group that size. I speculate that the independent practices that have remained those ones that have four or five, six, seven docs that are independent, those are the ones that everybody wants. They've held out this long. I don't think they're going to go without seeing a really hefty price tag. And
maybe US fertility now has that capital and interest in doing so. That's some speculation from my end.
But I wonder if we don't see the crazy high multiples that we saw in 2021.
if we don't see a few more of those this year.
My guess is that we see one to three other network seller consolidate in 2026.
All the while though, as my good friend Dr. Eduardo Heraton says, clinics are already at physical and human capacity limits.
so they're trying to grow.
but they're doing as much as they can right now. And that shortage affects operations and valuation.
because networks have to look at a clinic's ability to recruit and retain physicians and private equity firms need to look at a network's ability to grow by physician count.
There's some groups that have done a lot in that regard.
I Prelude is actually one of them. I talked with Dr. Jason Yee about Burnout.
and Dr. Ali Domar.
and how Inception is investing.
in nurturing their providers.
But I also remember from the report that Inside Reproductive Health did last year on where all the class of 2024 graduate fellows went to go work.
I want to say six of them went to go work for Prelude.
And that was third by a very, very close margin.
And that seems really high to me because at least at that time, Prelude didn't have a fellowship program.
to me that suggests they're doing something to be really attractive to younger doctors. I'll be interested to see if that's a trend. Inside Reproductive Health is going to do the same report for the class of 2025, just here in a couple months. And then later in the year, we'll do the class of 2026.
but they have to pull out all the stops to attract and retain docks.
because the demand for docs is insane.
Many of you know Dr. Ronald Feinberg, I saw a LinkedIn post of his.
think he took a snapshot of a job board.
The average starting salary for those, most of which were small markets, was $650K a year plus bonuses.
And when we did a survey just before the pandemic in 2020,
The average dollar amount that fellows were getting.
right after graduation was like 400K a year.
So as this bidding war for doctors intensifies.
lot of REIs are saying, what did we used to do? We used to open up our own practices and own and operate them? Maybe I'll give that a shot. There were three Boston IVF docs that left the Boston IVF last year. They opened Terra Fertility in September.
It was Pietro Bordoletto, Dennis Vaughn, and Emily Seidler.
And I like this move because they did it together.
These were three docs that I thought were going to take over that network.
you know, someday. But they decided to go off on their own together.
And I want that for other young REIs who are doing the same thing.
And I'm not saying that somebody should open their own practice, some people definitely should not.
Sometimes it's really great to work for a network. That's neither here nor there. I'm just saying if you are going off on your own, doing it solo is so much harder than doing it with three.
Unless that's what you want to do for the rest of your life. And some people do. But I think as IVF becomes a higher volume field of medicine, as self pay decreases and employer carve out companies and insurance.
Squeeze margins drive down reimbursement. I think it's gonna be really hard to be a single provider group
The value and leverage in a business is when you have
more providers. And it's a lot easier to get to five docs and then seven and then 10. When you're starting with three.
it's really hard to go from one to two even one to three when you're starting with just one.
I like that these Terra docs trusted each other. They like each other.
And when I talk to a lot of docs that are starting their own practices now,
Oftentimes to me it sounds like...
they're going back to the competitiveness that I often heard from independent practice owners 12 years ago.
Just sort of like a distrust of each other.
And I think it'll be hard to be a lone wolf.
I terror grows not insanely quickly.
but reasonably quickly, and that it shows the model of a physician-owned group.
where REIs can set aside their egos.
to work together to build a group that's much bigger than themselves.
Part of the reason this is all happening is I think that some people just don't see private equity.
as any less risky than starting their own thing.
I had Dr. Kyle Tobler and his partners at Idaho Center for Reproductive Medicine on the podcast.
And he says, look, when you do the math.
The is just so much more.
when you own it.
Pretty similarly, I Dr. Lauren Johnson of Carolina Conceptions. I had four of her partners with her on that same episode.
And she said, listen.
It could be even riskier working for a private equity back group. You don't know who's going to be at the table with you 10 or 15 years down the road.
And she looks at her partners and she's like, I know who these people are. I know what their values are. And I can count on them to be at the table with me.
And so for those doctors for whom owning a practice
is the right fit for them. I hope they seek out partners like that.
I think there's more resources for them now. Have you heard of Pop Art? People have been talking about it. Pop Art. think it stands for Physician-Owned Practice Alliance for Reproductive Technologies.
You might know Rhoda Rizkalla-Cavaris from Arizona, Dr. Julian Escobar from Texas. They formed an alliance.
for purchasing power for independent practices.
People have tried this in the past and it didn't work. I don't know why it didn't work. I'd like to see it work.
And so I'm glad to see pop art getting off the ground because people seem excited about it. People are telling me about it.
Networks are using their docs as differentiators, at least the good networks are.
Jason Yee is a prelude doc at Aspire Houston.
You always see the fellows hanging out with him at PCRS.
You can tell leadership.
is listening to his point of view.
because he points to that seven to ten year wall that a lot of REIs hit.
It's a tough time of career. It's often a tough phase of life with younger children.
And I think a lot of networks wouldn't want their docs talking about physician burnout.
Not only did Inception not try to stop that episode, they sponsored it.
They have a microphone.
to this doctor talking about.
these challenges that other REIs are facing.
because it's important to them. I also liked his point of view, as Dr. Yeh's point of view, is that we've got corporate leadership here, so that means that those clinical decisions are left in the hands of doctors. That actually means we have a lot of autonomy. So sometimes when you have a physician leader,
that is also the corporate leader.
They want to impose their clinical way.
And so his colleagues feel like they have a ton of autonomy.
And it's not just doctors.
that networks are using.
And Kind Body brought in David Stern as their CEO this year, last year.
That's a big name. That's somebody that has had success.
That's a move you do when you've... want to communicate.
to everyone. We're writing the ship here. We've got somebody that's done it before.
And I think.
Jason Barrett is probably an underestimated.
He's underestimated the right word, understated.
but powerful influence for Kind Body. I really think that he's a stabilizing force.
And there's a handful of senior lab leaders. The new generation of senior lab leaders. It's been like there's been a turnover the last few years.
that the current and ascending generation of young grand brella just really look up to. Michael Baker from Inceptions, one of them, Jason Barrett is definitely another.
And I think that adds to Kind Body's credibility.
CCRM is doing something cool.
They're using their marketing pipeline.
as a way of supporting and being attractive to doctors.
They'll do stuff with influencers in the patient space.
Instagram influencers, TikTok influencers.
people from underrepresented communities.
And then also.
You get some pretty good feature on legacy outlets like Pop Sugar and the Atlantic.
and then they'll throw that support to their doctors.
because younger doctors today.
really want help building their practice, they want to do it quickly. It's really hard to do it on their own.
we've been talking about the demand and scarcity of doctors. But the same can be said for almost all clinical staff and it can certainly be said for embryologists.
Embryology shortage might even be greater.
I think there's a lot of networks that hardly done squat.
for reducing the manual.
bullcrap that nurses and embryologists have to do. some that are still really far behind.
think there's a couple leaders
that are now kind of forcing others to catch up.
I like Innovations.
partnership with Alife for that reason
been here in Alife get a lot remarks. lot of people USF seem to really like them. Innovation seems to really like them.
And I think Innovation really takes the lab seriously.
Dwight their CEO Dwight Ryan
He's a veteran.
when it comes to developing IVF labs.
He's been doing it for decades, people turn to him for that exact And he's the CEO of innovation. He's also got Kathy Miller.
And Kathy has a ton of experience. Big labs that buy all the sexy toys.
Small labs.
that are probably analog as heck.
But think she's been.
big for them to have.
In Europe and Canada, the challenges are slightly different.
You got a lot more managed care over there in Europe at least.
But in general, Europeans feel like their healthcare system's getting worse.
I feel like it's stagnating.
The services are getting worse, but their taxes are going up.
and that it's just not a leader innovation and healthcare.
FutureLife seems to be bucking that trend.
Francisco Lobosco, he's their CEO.
He's positioned them as a technology enabled network.
they're really focused on a unified patient journey using systems that connect them.
They also acquired chain of clinics in Romania.
And they don't just use they use CRMs.
to support the patient journey.
Canada is different from Europe, should say. even though you have Health Canada...
And you have a public payer healthcare system in general, it's not the way fertility is most of fertility is self pay. But then you got the province of Ontario, which five or 10 years ago started their 10 years ago, probably started some funding and then they've expanded that
they've expanded their fertility funding a quarter of a bill.
and they have a 25 % tax credit.
problem with that is in Canada, you already have several month wait at a of clinics.
and you have people that are not paying for healthcare out of pocket. That's a bad combination.
I think the Fertility Partners is getting ahead of that.
They're investing.
in advancing, developing, and retaining their personnel.
They were given a great place to work certification.
talking about the workplace stability.
It's a good place for people to work.
even his patient volume soar. And now they have a new CEO. believe her name is Heather Stark.
was the CFO.
We'll be interested to see how her vision comes to fruition.
If you want to attract younger docs,
Research is going to set you apart for a good cohort of them.
There are a ton of docs that do not want to give up on research. Got to figure out a way to work it into the business model. Make it work for you, make it work for them. Preg has done that. I like the people at John Nichols, John Payne, they've been friends of mine. Faith Ripley is somebody I've admired for a long time.
They grew their group to nine REIs.
That's just freaking impressive.
And they were also part of, I believe it was Univfy's study.
showing how their prediction model outperform the national SART benchmark allowed center specific outcome forecasting. That's the stuff that younger doctors want. And imagine that's only one of a myriad of reasons of why pregnant has been able to recruit so many docs.
That's all in pretty much one geographic area to give or take in the greater South Carolina area.
And besides research, safety. Nobody wants their frickin' name in the paper. Not for a lawsuit, I mean. Not for a terrible...
gamete mismatch or something like that. Had Dr. Steve Kaz, Dr. Schenkman on in the beginning of last year.
Dr. Katz said, we're pushing for our IVF labs. He said, I want all of them to have electronic witnessing.
I hope he was successful in that.
I think people are listening. Pinnacle's super interesting to me. They've done some...
things that I've been waiting for Fertility Center Networks to do, one of which was unify the Brand. I had that conversation with Mark Siegel many years ago.
And he's asking, what do you think? Do you leave these individual branded names? Kind of like how Boston IVF did.
Or do you have a universal brand equity?
And I believe in the latter. There's pros and cons, of course, everything's a trade off. It's probably really scary to do.
Pinnacle took the plunge.
No, it's Pinnacle, Seattle. Pinnacle, Arizona.
You have to have a national flag.
in order to unite everyone under the nation, you know what mean? If everybody just has loyalty to their state flag, then ⁓ this national identity, that's just some...
parent company. And it's really hard to have a unified patient experience and the unified operations that support that. But back to safety.
Beth Zonreich and her team built an in-house electronic witnessing platform.
They say it's working. They also say that it saved them a million dollars annually.
I think there's a lot to go in each column of the buy versus build debate.
If that is the case.
That would be a huge thumb press.
on the scale for the side of build.
IVI RMA became the first and only reproductive medic
It's an organization in the United States to receive a federally recognized patient safety organization designation.
They created the Institute for Safety and Reproductive Medicine.
And as I told their COO, Iris Gonzalez.
I've gotten to their chief medical officer, Tom Molinaro, and their CEO, Lynn Mason, just a tiny bit.
Not super well, but just enough to believe them when they talk about their style of dyad leadership, that they genuinely support each other. And I think that trickles down to how all the physicians and business people view and support each other.
safety, war for talent.
Couple of the bigger independent practice groups maybe going for crazy multiples like they were a few years back.
Probably one, even two or three networks bought or consolidating. These are the things that I expect for 2026.
for you doctors going off on your own. Hell yes, I support you.
Some of you should absolutely work for networks. For some of you, that's a way better deal.
But I do think we need more of those five, seven, eight, 10 doctor independently owned physician only owned groups.
in order to spur more innovation in this field. Otherwise, the concentration of buyers is too small, makes it harder for new technologies to get adopted.
because they have to customize way too much.
and it really delays.
finding that product market fit.
among other reasons. That's why I want to see independent groups of that size again. And so for those of you
who are called to own your own practice.
I just hope you take seriously getting to know your colleagues, trying to establish genuine, affectionate, trusting relationships with them.
so that maybe you don't have to go it alone. Maybe a group of you could do something really special.
Griffin Jones
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