U.S. Fertility Clinics & Infertility Services: An Industry Analysis

Date: October 1, 2013
Pages: 123
US$ 995.00
Publisher: Marketdata Enterprises
Report type: Strategic Report
Delivery: E-mail Delivery (PDF)

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This analysis by Marketdata examines a controversial $3.5 billion healthcare service sector — infertility services. This loosely regulated “baby business” has weathered the last recession pretty well and is past the Nadya Suleman (OctoMom) case, which brought up issues of unethical practices by some fertility doctors practicing “assisted reproductive technology” (ART) and implanting multiple embryos.

ART now produces more than 50,000 babies per year in the U.S. via 152,000 IVF procedures, and demand is growing from the ranks of 7+ million infertile women, many of which delayed childbearing due to careers. Foreigners and gay couples are two other areas of growth. There are 481 U.S. fertility clinics, 100+ sperm banks, an unknown number of egg donors, and 1,700 reproductive endocrinologists competing for the business, which is lucrative. In addition, the global market for fertility drugs tops $1 billion. Only one corporate “chain”, IntegraMed, exists, as most programs are run by small MD practices or are part of a hospital or University.

This 2nd edition study by Marketdata examines the nature/evolution of the business, national receipts/growth from 1988 to 2018 forecast, infertile customer demographics, key industry trends, industry regulation, pricing, industry consolidation, insurance coverage, ethical issues, effects of the last recession, and more. The study presents the findings of fertility clinic managers, with average costs and number of specific diagnostic procedures. Contains results of the latest (2011) CDC ART survey national data, with IVF success rates and long-term trends, as well as European ART cycles survey data. The report also examines the nature/size of the U.S. sperm banks, egg donors, and fertility drugs markets, and surrogacy programs.

Competitor Profiles for: Cryos International, California Cryobank, Resolve, Allan Guttmacher Institute, Genetics and IVF Institute, IntegraMed America.

This study is believed to be one of the few in-depth publicly available business analyses that exists of this market. It’s ALL here in one place.

  Report Scope & Methodology, Sources used


  Analysis of fertility treatment services industry: nature of the field, no. of ART clinics, how patients pay/insurance, ethical issues, status of state &Federal regulation, treatment methods (diagnostic, therapeutic approaches, no. of procedures performed per year and cost), infertile customer demographics, results of Marketdata interviews, industry size/growth/segments (1988-2018F – 2012-2013 performance, effects of 2009 recession, $ value of mkt segments: MD consults, semen & hormone analyses, tubal reversals, IVF and GIFT procedures, fertility drugs mkt., sperm banks, egg donor mkts.), discussion of rationale for future growth, ranking of top 20 competitors, patient demographics.


  Definition of market segments (IVF clinics, sperm banks, egg donors, fertility drugs, surrogacy programs, surgeries)
  Industry evolution – when clinics first appeared
  Market demand and potential: Number and percent of women of childbearing age infertile, increase in IVF procedures from 1987-2011, reasons for continued growth, past estimates of industry size
  Insurance coverage: typical fees and client affordability, state mandated coverage, financing
  Pending legislation: The Family Act, Personhood bills.
  Causes of infertility: discussion of main reasons for infertility in men and women, treatment methods (HSG procedures, lap and dye procedures – description, cost, estimated number of procedures). Tubal reversal surgeries (description of, success rates, costs, percent of women having procedure, estimated number of surgeries).
  IVF procedures: discussion of procedure, cost. GIFT procedures: discussion of procedure, cost, number of procedures.
  Ethical guidelines and government regulation of clinics: status report.


  Summary and discussion of number and percent of infertile female population in the U.S. (U.S. Census Bureau data, American Society for Reproductive Medicine)
  Reasons why the market is largely untapped: how price deters most candidates
  Recent birth rate/birth control trends: analysis of why birth control rises during recession and birth rates fall, effect of last recession
  Delayer boom: more educated women have children later in life
  IVF tourism increases for European couples due to U.S. economy and progressive laws
  Health status: percent of women age 18-44 reporting receiving infertility services (by race, age, type service)
  Fertility of American women: 2008 Report (U.S. Census Bureau – highlights of the report) (birth rates and fertility rates by race, education, state, income), level of childlessness by age, race
  Cumulative fertility for women 40-44 years old
  Current fertility rates
  Marital status and cohabitation
  Citizenship status, race and Hispanic origin
  Educational attainment
  Birth rates: data for 2011 – report highlights regarding number of births, total births in the United States, crude birth rate, general fertility rate


  Women aged 18-44 who have ever received infertility services, by race/ethnicity
  Women aged 18-44 who have had an infertility related medical appointed in the past year, by age
  Number of married women 15-44 years of age and percentage who have had a sterilizing operation by type of operation and percentage whose husband has had a vasectomy, by selected characteristics: United States
  Number of women 15-44 years of age, percentage who have ever received any fertility services, and percentage who have ever received the specified infertility


  Summary and Analysis; historical estimates of industry size – 1988,1995, 2000 (gov’t. & private sources)
  Marketdata estimate of mkt. size in 1999, by diagnostic procedure, IVF, drugs, surgeries
  Harvard Business School estimate for 2004
  Discussion of no. of IVF clinics 1985-2011, avg. revenues, value of this segment
  2009-2012 market performance: estimated growth, impact of recession, pricing, Integramed revenues.
  2012-2013 market performance: discussion of key factors: recession, healthcare reform, small clinics vs. IntegraMed performance, demographics, Marketdata forecast of IVF volume, $ value of the market.
  2018 Forecast: Factors affecting current and future industry growth: IVF tourism, economic recovery, public policy, improved success rates, gay/lesbian use of IVF, etc.
  Status of the European Market, report of ESHRE, IVF volume, percent distribution of IVF vs. ICSI (1997-2009), which nations infertile couples come from, reasons, reimbursement ESHRE headquarters address.


  Size of fertility services industry – 1999: diagnostic & therapeutic procedures (no. performed, avg. cost, estd. $ value: office consultations, semen analysis, hormone evaluations, tubal reversals, IVF & GIFT procedures, fertility drugs, donor eggs, donor sperm, surrogacies)
  Size of fertility treatment industry: 2004 (Debora Spar, Harvard Business School book)
  No. of IVF procedures performed: 1998-2011 (CDC data)
  Top 21 U.S. fertility clinics, by no. of IVF cycles performed: 2006, 2008, 2011
  Size of fertility services industry – 20012 vs. 2008: diagnostic & therapeutic procedures (no. performed, avg. cost, estd. $ value) – breakdowns as above
  Estimated historical size of mkt., by segment: 1988, 1995, 2000, 2004, 2006, 2008, 2012
  No. of cycles performed in various European nations: 2009.


  Summary of the U.S. & global fertility drugs market: estimated size, key competitors (Organon, Merck Serono, Ferring)
  Outlook and sales results from Merck’s 1995-2012 annual reports for North America versus rest of world, outlook for Gonal-f and Pergoveris
  Estimated market share for Merck Serono, $ sales
  Discussion of increase in illicit drug market developing between buyers and sellers
  Marketdata estimates of fertility drug sales: 1995 – 2018F, five year forecast


Sperm Banks
  Summary and discussion: number of U.S. sperm banks, typical fees, main activities
  How the process works: requirements and screening of sperm donors, who typical donors are, fees, contracts
  Estimated value of the market: 2004 – 2018F
  Market trends – why market is flat, gray market sperm
  Major competitor Profiles: Cryos International Sperm Bank (Denmark), California Cryobank – typical procedures and requirements of donors, findings of phone interview
Egg Donation
  Discussion of egg donors, fees, who they are, differentiated pricing structure, estimated market Value: why this is a strong growth market, foreign demand, market size: 2004-2018 Forecast.
Surrogacy Programs: Discussion of the need for it, mkt. size, fees, etc.


  Findings of 2011 survey: success rates, by age of woman, fresh & frozen embryos from nondonor eggs, donor eggs, percent of clinics offering services by type.
  Discussion/analysis of: type ART procedure used, pregnancy success rates, ART cycles using frozen embryos, ART cycles using donor eggs, ART cycles using nondonor eggs and embryos, success rates by women’s age
Tables and analyses of 2011 report: National Summary
  Total no. of ART procedures performed, % by type.
  No. of infants born through ART
  Percent multiple birth deliveries
  Percent of ART transfers resulting in a pregnancy.
Text, analyses & discussion covering these topics: (2001-2010 long-term trend data)
  Is the use of ART increasing? Is the use of ICSI increasing?
  Have there been changes in the type of ART cycles performed among women who used fresh or frozen nondonor eggs or embryos?
  Improvements in % of transfers resulting in live/singleton births among women using fresh/frozen eggs (by age group)
  Has the no. of embryos transferred in fresh non-donor cycles changed?
  Has the no. of embryos transferred in each ART cycle changed for women under 35?
  Have there been improvements in ART success rates by no. of embryos transferred?
  Has the % of multiple-infant live births changed?
  Has the % of singletons, twins and triplets or more changed for ART cycles using fresh non-donor eggs or embryos?


Results of custom Marketdata survey (June-July 2009)
  Number of new patient visits per year
  Average cost of new patient consult
  Average cost of a semen analysis
  Average cost of a hormone evaluation
  Average cost of a HSG
  Average cost of a tubal reversal surgery


Summary: discussion of consolidation, how larger clinics are capturing greater share of the market


  Ranking of top 21 IVF clinics, by no. of cycles performed: 2006, 2010, 2011
  Ranking of top 21 IVF clinics, by. no. of cycles performed and estd. revenues per clinic in 2011
Descriptions of activities, specialties, mission, 2006-2008 revenues if available, address, for:
  Allan Guttmacher Institute
  Genetics and IVF Institute
  IntegraMed America, Inc.


  List of adoption and fertility services industry trade groups, associations, surveys, consultants, and other sources.
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