The Rapidly Changing World of Infertility Practice: Where will it lead to?

This article describes the radical changes in business models driving infertility care since the inception of IVF, which created the impetus for establishing a separate sub-specialty of Reproductive Endocrinology and Infertility (REI). We here describe how this small new sub-specialty area of gynecology over 45 years grew into a highly influential subspecialty and, ultimately, into a true “industry,” supported by ever-larger numbers of provider clinics and, in parallel, an equally quickly growing full-service support industry. With the finance world for several good reasons, discovering fertility as a growth industry, the world has, especially over the last decade, witnessed an acceleration in the pace of change, the largest likely being that only a minority of individual IVF clinic sites in the U.S. are still physician-owned. Throughout the country, but especially in larger cities, it appears that Wall Street has taken over, with large national chains of IVF clinics, mostly owned by private equity, buying up physician-owned clinics at a record pace to compete for market share. How these developments have already greatly affected the provision of fertility services and where they will lead is the topic of this article, with, of course, particular attention to the New York Tristate area.