The Battle to Determine Fertility Networks’ Valuations
None of the organizations or individuals mentioned in this article reviewed nor had editorial control over its content.
BY GRIFFIN JONES
Acting Editor, Inside Reproductive Health
As Private equity firms try to sell their fertility clinic networks, the drive to increase value weighs short-term profitability against long-term interests. Buyers and sellers jockey to establish the optimal balance.
The fertility field’s 2025 has been marked by far fewer clinic acquisitions than recent years, tighter private-equity cycles, and an increased focus on profitability over expansion.
While consolidation remains one of the fertility sector’s hot topics, its pace has slowed. Inside Reproductive Health (IRH) reported that only three fertility clinics were purchased by networks in 2025 to date in the United States.
Sector experts say the lull is likely the caesura before the crescendo.
After a decade of rapid private-equity investment and aggressive fertility clinic consolidation, they expect networks to consolidate and/or new private equity partners to enter.
“Most of the large networks’ private-equity partners are in the latter stages of the funds that financed their acquisitions, so they will be looking for exits,” Dr. David Sable, managing director at Special Situations Life Sciences Fund, told IRH.
IRH Launches Live Hub for Fertility
Don't Miss What These Companies Did
Cost Control vs Everything Else
That market timing reshaped how capital moves through reproductive health. The central theme of the fertility market in 2025 might be characterized as the battle of the opposing forces that shape the market value of a fertility clinic network.
While there are multiple forces, one is the anchor: protect the bottom line. The largest networks, who sometimes paid multiples upward of 15x EBITDA for fertility centers with multiple reproductive endocrinologists (REI), are increasingly wary of expenditures.
“A sale process with price determined by existing cash flow calculations,” Sable added, “would be a disincentive to investing in anything not immediately accretive.”
As networks prepare for private-equity exits, downward pricing pressure has intensified across nearly every industry category.
But while IVF volumes climb incrementally, clinics and networks have to weigh the benefit of short-term cost control against data-driven standardization, efficiency through automation, and patient-experience-focused partnerships.
To defend and increase their market valuations, fertility centers need to maintain new patient pipelines, retain patients and convert them to treatment, all while they still face limits in recruiting, retaining, and maximizing the productivity of their workforce,
Vs. Workforce Constraints
Clinics and labs who would otherwise delay new capital expenditures, find themselves having to invest in new technologies because of the limitations of their human capital. Workforce constraints remain the sector’s defining bottleneck.
“We are already at physical and human capacity limits, with embryologists and REIs in particularly short supply,” said Dr. Eduardo Hariton, Vice President of Strategic Initiatives at US Fertility.
Fertility centers who drive toward more IVF volumes, without investing in support for providers, risk losing the scarce number of providers and staff they currently have.
“It would feel physically uncomfortable for [most] doctors to start hitting 350, 400 cycles.” said Dr. Jason Yeh of Aspire Houston on a podcast episode titled Fertility Doctors Are Burnt Out, one of IRH’s most shared interviews of 2025. “That's where I think life starts to sound crazy.”
Dr. Yeh added that not all networks are equal in the pressure placed on physicians’ performance, mentioning measures taken by Inception Fertility to protect physicians from burnout.
To guard providers and patients from problems caused by labor shortages, centers and networks are finding reprieve in support services who have proven success with other groups. In genetics, clinics from networks such as US Fertility, RMA, and CCRM rely on GeneScreen’s counseling and PGT support to mitigate risk and improve patient education.
Kindbody’s Dr. Lynn Westphal, and Shady Grove Fertility’s Southern Virginia surgery center, use Kaleidoscope Anesthesia Associates to staff and manage anesthesia operations to improve workflow efficiency and reduce surgical delays.
Workforce changes on the industry side of the fertility space are developing. Ferring Pharmaceuticals announced it is laying off 500 employees, but it has not yet been reported on if or how many of them are from the United States or its fertility division.
Vs. Growth and Standardization
“While adding more providers—APPs and OB/GYNs—helps relieve pressure, the real gamechanger will be integrating technology that meaningfully increases provider efficiency and throughput”, Dr. Hariton told IRH. He said clinics and networks, and their financial backers are still investing in tech enabled standardization.
Conceivable Life Sciences’ $50 million Series A round supported the point that investors believe that IVF services can be scaled by automation and robotics . Conceivable aims to shorten treatment cycles and standardize IVF operations by automating the embryology lab. The fund was announced five weeks after the passing of Conceivable’s co-founder, Joshua Abram.
Most IVF lab leaders now view time lapse incubators as necessary in the embryology lab. Their reasons have less to do with clinical outcomes, whose improvement they say the evidence does not yet fully indicate, but rather with standardization. They say they have a modest preference for the EmbryoScope due to integration depth and reliability.
Dr. Denny Sakkas, Chief Scientific Officer of Boston IVF, told IRH that he expects almost all IVF labs in the United States to have some version of time lapse imaging within roughly five years.
Dr. Hariton explained the broader trend driving standardization in clinics and labs. “As large networks consolidate and aggregate data, the ability to generate meaningful insights grows exponentially,” he told IRH. “This creates the opportunity to move toward more protocolized care—standardizing where personalization doesn’t improve outcomes—so we can simultaneously improve efficiency, scale, and success rates.”
IRH Launches Live Hub for Fertility
Don't Miss What These Companies Did
Vs. Patient Experience
Clinics cut costs and buy commodities from the lowest bidder when possible, but vendors who erode patient experience are a liability to a fertility network’s growth and valuation.
The Management Service Organizations (MSO) must demonstrate strong new patient pipelines, sustained patient retention, and increased conversion to IVF, in order to satisfy potential buyers. As such, patient experience remains at the top of executive agendas.
Fertility physicians such as Dr. Tom Hannam emphasized that retention depends as much on communication and transparency as on clinical outcomes.
“Taking the stop and wait approach in today's age of instant gratification is no longer acceptable,” said Dr. Roohi Jeelani, a Chicago based REI who expects to finish 2025 having performed over 1,600 egg retrievals, more than eight times the national average. “Fertility clinics need automated systems to set expectations around timelines, costs, and likely outcomes. When patients reach the REI, the time must be spent on personalized, empathetic, human-centered care instead of general conversations that are less likely to move the patient forward”.
Because of the countering pressure of patient experience, networks continue to enter into engagements with select partners who demonstrably improve patient engagement. Pharmacy is a clear example. MSOs contract with pharmacies primarily on cost—unless the vendor can improve their clinics’ overall patient satisfaction, such as comparing Mandell’s Speciality Pharmacy’s 4.8 Google rating to fertility pharmacies with a 2.4 Google rating.
Vs. Legal Liability and Safety
Capital risk firms who purchase fertility clinics and networks are looking to see how well protected clinics and labs are from rising litigation that could threaten their investment.
“There's groups of plaintiffs attorneys who have fixed their attention on the reproductive health space, IVF clinics in particular”. Matt Maruca, Chief Legal Officer at Inception Fertility, said on an IRH podcast interview. “The amount of litigation that we see has increased quite a bit [over the last six years]”.
Maruca discussed measures added by Inception to enhance safety and legal protections. He also pointed to efforts of the Fertility Providers Alliance (FPA) and the American Society of Reproductive Medicine (ASRM) to be vigilant of political and legislative moves that would limit access to IVF.
A report issued by the Heritage Foundation this year urged strict restrictions or bans on embryo disposition and third-party reproduction. Regarding private equity in medicine, the state of Oregon passed a law that restricts capital risk firms’ role in healthcare ownership.
As a result of the prioritization of safety in the lab, electronic witnessing systems are now viewed by most embryology leaders as essential, despite their currently low adoption rate. One network took its own approach to win the trade off between cost control and lab safety. Pinnacle Fertility implemented an in-house witnessing system that reportedly saves $1 million per year, instead of purchasing from a vendor.
At the policy level, the White House Executive Order on Advancing Biotechnology and Biomanufacturing Innovation, was issued in February, but hadn’t translated into fertility-specific directives until October 16. The Trump administration struck a deal with EMD Serono to discount Gonal-F at what the White House says is 796% of the regular price. Pharma insiders said it remains to be seen how the move will affect pharmacies and other drug makers.
The privilege with TrumpRx may be a way to blunt the increase in market share of Organon’s Folistim. “If you go back eight, seven years ago, it was maybe more of a Gonal-F heavy market,” Dr. Ravi Gada explained on the Inside Reproductive Health podcast. “If you look today, I think the market has shifted and it's probably leaning (toward) Folistim. They've had some big wins in the last five years.”
What to Expect in 2026
Other trends that will be monitored in 2026 include the increased or decreased speed of growth of employer-covered IVF and developments in the pharmaceutical sector.
Still, the defining storyline for 2026 is expected to center on private equity exits. As major fertility networks reach the end of their investment cycles , new ownership will set the benchmarks for valuation and strategy. The expected sale of US Fertility, now in its second bidding round, according to ION analytics, could be the first to set the bar.
Dr. Sable expects that, regardless of who goes first, upcoming transactions will set the benchmark for EBITDA multiples and determine which investors remain active.
“In the next six to twelve months, the big story is going to be what happens—or does not happen—in large network consolidation,” he said.
More Headlines You Should Know
Inside Reproductive Health launched a platform that includes information about almost every company on the industry side of the fertility field.
IRH says it is the start of the business intelligence hub for the fertility space. Clinic information, more company data, and market information from IRH’s Fertility Industry Reports, are expected to be added next year.
IRH Launches Live Hub for Fertility
Don't Miss What These Companies Did
None of the organizations or individuals mentioned in this article reviewed nor had editorial control over its content.