News
How chain IVF clinics improve infertility treatment
In the U.S., demand for in vitro fertilisation (IVF) increased almost 140 per cent between 2004 and 2018, with chains now performing over 40 per cent of IVF treatment cycles nationwide.
The new study by La Forgia provides a more optimistic view in the case of fertility clinics, suggesting chain ownership has improved results. The researchers found that clinics acquired by a chain serve more patients, increasing IVF treatment cycles by 27 per cent, and they increase live birth rates by nearly 14 per cent.
“Chain organizations are very common in hotels and restaurants,” says Ambar La Forgia, an assistant professor at the Haas School of Business, UC Berkeley. “But when it comes to healthcare, because it hasn’t traditionally been delivered in this way, it seems to be making a lot of people uneasy.”
Policymakers are particularly concerned that chains will chase profit at the expense of patient outcomes.
The study has been published in Management Science and co-authored by Julia Bodner of Copenhagen Business School.
Significant improvement with chain clinics
IVF treatment cycles comprise five main stages that require over 100 distinct steps performed over four to six weeks. Along the way, many subjective decisions must be made.
The goal, of course, is to produce healthy babies, and the last step—when a physician transfers an embryo, or embryos, into a patient’s uterus—is particularly important. Transferring more than one embryo increases the success rate, which is measured by the number of live births divided by number of transfers, but it also increases the chance of multiple births, like twins, which is riskier for both the mother and the newborns.
To compare the performance of chain and independent clinics, La Forgia and Bodner collated a novel set of clinic and patient data that drew from the Centers for Disease Control, and the National Center for Health Statistics.
They also manually checked the ownership of every fertility clinic in the U.S. From this effort, they were able to look at two main outcomes between the years 2004 and 2018: How many IVF cycles does each clinic perform? And what is the success rate, measured by live births per transfer?
The researchers found that after a fertility chain acquires a clinic, IVF cycles increase dramatically and live birth rates increase by 13.6 per cent.
“This means that these chain clinics are doing more cycles of IVF and converting more of those cycles into live births,” La Forgia says. “They are actually improving the quality of care in a meaningful way.”
Chain clinics are not doing this by simply transferring a lot more embryos, either. La Forgia and Bodner find that they are actually producing more “singleton” births—that is, the birth of one baby—than their independent clinic peers, which implicitly suggests a better embryo selection process.
A product of more resources and knowledge
But what if these results are driven by a more stringent patient screening process, or by chains being more selective about the markets in which they operate?
La Forgia and Bodner investigated these possibilities and found no supporting evidence. There is no appreciable change in the patient population after a chain takes over an independent clinic. In fact, the largest improvement in live births is among patients who are 38 years old and older—the population that typically has the lowest success rates. Nor are their significant differences in the broader demographics of neighborhoods in which chain clinics operate, the researchers found.
Instead, it appears that chains improve outcomes through two mechanisms: the availability of more resources and a heavier focus on sharing best practices. The researchers make this case through several analyses. For instance, chains tend to introduce new processes and procedures known to improve birth rates. In fact, the lowest-performing clinics see the largest improvements when taken over by a chain, and clinics acquired by the highest-performing chains experience the greatest improvements.
Most notably, the researchers found that affiliated IVF clinics, which pay chains for select management support and financing options but retain managerial independence, witness an increase in patient volume and number of IVF cycles, but unlike fully acquired clinics, they don’t demonstrate an improvement in birth rates.
“Basically, in affiliated clinics the number of live births is going up as an absolute value, but they’re not getting better at achieving live births,” La Forgia says. “Our hypothesis is that a chain is willing to share its resources widely, but it may not want to share specific knowledge with an organisation it doesn’t own, so we’ll only see this knowledge transfer in acquired clinics.”
The authors demonstrated a final benefit of chains, which is that they increase access to IVF by expanding the market—performing more IVF cycles—rather than stealing business from competitors.
Supporting a better healthcare market
Some of the findings may be explained by the fact that compared with many other parts of the healthcare system, fertility clinics share some characteristics with retail stores and chain restaurants. It’s a relatively more competitive market and patients typically pay up front and out-of-pocket for care.
Clinics are also legally required to send their data to the government. Other sectors like dialysis and nursing care are more opaque and dependent on insurance, so chains may have fewer incentives to improve quality of care. But the researchers point out that plenty of health care is shifting toward a retail model, including dermatology providers, urgent care clinics, and physical therapists.
The authors offer three recommendations to help these markets support the kind of competition that ultimately improves patient outcomes.
- Policymakers should increase transparency about quality of care. In the fertility sector, clinics are legally required to send their data to the government, which publishes them as an online report card, so patients can shop around.
- Price transparency is necessary to increase competition among providers. In most healthcare settings, patients do not know how much they will pay, often until months after treatment. Since patients typically pay up front for fertility treatments, clinic chains may compete more on prices to attract new patients.
- Finally, regulators should make sure patients have sufficient choice. In the dialysis market, for instance, two companies own 60% of clinics. Such concentration of power may negatively affect both prices and quality. As chains expand, regulators should make sure this growth doesn’t hinder patient choice.
“Very little research speaks to the ways in which chains are good or bad for patients,” La Forgia says.
“We ought to start paying attention to what kinds of markets might lend themselves well to this business model.”
Insight
Women’s HealthX launches in Boston this December to transform women’s health through data and science
On December 3–4, 2026 in Boston, Women’s HealthX (WoHX) will bring together 750 global leaders from pharma and biotech, hospitals and health systems, health insurers, employers, investors, startups, and government, all actively seeking proven technologies, data, and partners to advance women’s health care, research, and outcomes across the life course.
WoHX is the number one event in women’s health, unifying the full lifecycle of female healthcare through data, science, and evidence-based innovation to close the sex difference data gap and drive better clinical outcomes for women worldwide
Unlike any other event, WoHX goes beyond discussion to focus on implementation of representative data sets to drive meaningful change. The exhibition directly addresses the conditions that affect women differently and disproportionately, across every stage of life.
Attendees will gain clear insight into which areas are overhyped versus underfunded, where the biggest evidence gaps remain, and how data, science, and evidence can drive measurable change in policy, reimbursement, product development, and clinical practice.
Julie Rios, Division Director, Reproductive Endocrinology & Infertility at UPMC, shared why she is looking forward to attending:
She said: “I’m looking forward to connecting with innovators across women’s health to explore new technologies, collaborations, and care models that can help us solve our most complex reproductive health cases and improve outcomes for patients who currently have limited options.”
Taking place in Boston, the global hub for healthcare innovation, research, and medical institutions, whose collaborative ecosystem aligns perfectly with WoHX’s mission to accelerate the adoption of clinical solutions, and improve outcomes for women worldwide.
Across seven dedicated stages spanning Evidence, Data & Innovation, Fertility & Reproductive Health, Menopause & Healthy Aging, Maternity & Maternal Care, Sexual Health & Wellness, Cognitive Health & Wellness, and Chronic Disease Management, attendees will benefit from:
- 100+ hours of free education from 150+ expert speakers
- Direct access to senior decision-makers and key industry leaders
- Tailored one-to-one meetings with solution providers across medical devices, CROs, and analytics software
- Hands-on exploration of AI-powered tools, digital therapeutics, wearables, telehealth, and integrated care models via the interactive HealthXpo floor, featuring live demonstrations and hands-on clinical showcases
- The Women’s Health Startup Zone, connecting founders directly with investors
- The Career Zone, linking attendees with postgraduate programs, universities, and research centres, alongside masterclasses in AI literacy, data analytics, and research innovation
Early confirmed speakers include:
- Michael Annichine, CEO, Magee-Womens Research Institute and Foundation
- David Friend, Chief Science Officer, Daré Bioscience
- Emily Lau, Director, Women’s Heart Health Program, Brigham and Women’s Hospital
- Carolee Lee, CEO & Founder, WHAM
- Suneela Vegunta, Vice Chair, Women’s Health Research Division, Mayo Clinic
- Barb DePree, Director of Women’s Health, Holland Hospital
- Jodi Neuhauser, Founder & CEO, In Women’s Health
- Julie Rios, Division Director, Reproductive Endocrinology & Infertility, UPMC
- Kesha O’Reilly, Global Director, Medical Affairs HIV Franchise, Gilead Sciences
- Katie Baca-Motes, CEO GSD, Health Research
- Catherine Monk, Founding Director, Center for the Transition to Parenthood
- Mitzi Krockover, CEO & Founder, WomanCentered
Further announcements, including speaker confirmations and agenda highlights, will be released in the coming months.
Because Women’s HealthX believes in healthcare equity, attendance is free for practitioners within pharma, biotech, corporate enterprises, and medical officers and leaders within hospital and healthcare systems.
Register your free place now: https://www.alphaevents.com/events-whx/srspricing#/?utm_source=FemTechW&utm_medium=Media%20Partner&utm_campaign=52531.001%20-%20WHX%20-%20MP%20-%20FemTech%20World%20-%20Press%20Release&utm_term=&utm_content=&disc=&extTreatId=7631829
Oura has launched its first proprietary women’s health AI model to provide personalised insights across reproductive health, the wearable ring maker has said.
The model powers the company’s existing AI chatbot, Oura Advisor, and supports questions spanning the reproductive health spectrum, from early menstrual cycles through to menopause.
It is rolling out through Oura Labs, the company’s opt-in experimental feature hub within the Oura app.
Oura says the women’s health AI model draws on established medical standards, research and knowledge sources reviewed by its in-house team of board-certified clinicians and women’s health experts.
It also analyses biometric signals and long-term trends, including sleep, activity, menstrual cycle, pregnancy and stress data, to tailor guidance.
Ricky Bloomfield, chief medical officer at Oura, said: “This custom model is a fundamental shift in how we responsibly deploy AI in health to meet the needs of our members.
“Women’s health is too complex, and too often overlooked, to rely on one-size-fits-all systems.
“By designing a model specifically for women and grounding it in trusted clinical science and real-world biometric data, we’re setting the standard for how responsible intelligence should be built and expanded across more areas of health, pairing rigorous science with the lived, longitudinal data that makes Oura uniquely powerful.”
The company said the model is intentionally designed to be non-dismissive, reassuring and emotionally supportive, but stressed that the chatbot is not intended to replace a doctor or be used for diagnosis or treatment plans.
The launch comes after Oura said its fastest-growing user segment is women in their early twenties, according to chief commercial officer Dorothy Kilroy.
Oura said the model is hosted entirely on company-controlled infrastructure and that conversations are never shared or sold. Users can access it by opting into Oura Labs within the app.
Women are not protected from heart attack even though they usually have less artery plaque than men, according to a study of more than 4,200 adults.
Researchers found that heart attack and chest pain risk in women began at lower levels of artery plaque, the fatty material that builds up inside blood vessels and can restrict blood flow to the heart.
Risk also increased more rapidly in women than in men, particularly after menopause.
The research was carried out by scientists at Harvard Medical School and Massachusetts General Hospital in Boston.
Borek Foldyna, assistant professor in radiology at Harvard Medical School, said: “Our findings underscore that women are not ‘protected’ from coronary events despite having lower plaque volumes.
“Because women have smaller coronary arteries, a small amount of plaque can have a bigger impact.
“Moderate increases in plaque burden appear to have disproportionate risk in women, suggesting that standard definitions of high risk may underestimate risk in women.”
The study analysed health data from more than 4,200 adults with stable chest pain and no previous coronary artery disease.
Participants underwent diagnostic evaluation using coronary computed tomography angiography, a specialised X-ray scan of the heart’s arteries, and were followed for about two years.
Fewer women had plaque in their coronary arteries than men, with plaque present in 55 per cent of women compared with 75 per cent of men.
Women also had a lower overall plaque volume. Despite this, women were nearly as likely as men to die from any cause, have a non-fatal heart attack or be hospitalised for chest pain.
The analysis showed that women’s risk began to rise when plaque burden reached 20 per cent, compared with 28 per cent in men. As plaque levels increased, risk rose more sharply in women.
Heart disease is the leading cause of illness and death in the US and worldwide, according to the American Heart Association.
Cardiovascular disease was responsible for 433,254 deaths among females of all ages in the US, accounting for 47.3 per cent of deaths from the condition.
Stacey E. Rosen is volunteer president of the American Heart Association and executive director of the Katz Institute for Women’s Health at Northwell Health in New York City.
She said: “These findings are another important example of why it is imperative to recognise that cardiovascular disease can impact men and women so differently.
“There is an overdue recognition of fundamental, biological differences in the way health conditions manifest in women versus men, and these differences can influence everything from risk factors to symptoms to treatment response.
“I’m heartened to see more research such as this emerging as we address ways to reduce cardiovascular disease burden among all people.”
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