Original research

Do the big fertility brands deliver better outcomes?

Five brands operate 4 or more U.S. fertility clinics each. Between them they run 38 of the 422 clinics that report to the CDC — about 9%. 4 of the five score above the rest of the field. But the distance between the best and worst location of the same brand is as large as the distance between brands, which means the name on the door tells you less than the address does.

Every location, not just the average

One dot per clinic, on our 0–100 composite. The vertical rule is the median of every clinic outside these five brands. With 4–11 clinics per brand these averages are suggestive, not conclusive — which is why every location is plotted rather than summarized away.

Everything else: 327 rated clinics, mean 56.6, median 54.7.

What this does and does not show

RMA scores highest, 23.6 points above the rest of the field. That is a real gap. But Boston IVF's own locations range from 41.7 to 75.1 — a 33.4-point spread inside one brand, wider than the gap that separates the top brand from the field. A patient choosing on the strength of a name is using a signal that is weaker than the one sitting on the clinic's own profile page.

These are small samples. Four to eleven clinics per brand cannot settle whether a brand is truly better, and we have not run a significance test because with numbers this small it would dress up a hunch. The honest reading is that brand membership is a poor proxy for the thing you can simply look up per clinic.

Why this is about brands, not owners

The study we set out to run was about private equity. Roughly half of U.S. IVF cycles now happen at PE- or VC-affiliated clinics, and how those platforms perform is a genuinely open question. We could not answer it honestly, and the reason is worth reporting.

The CDC registry carries no ownership field. The only ownership signal available is the clinic's own name — and the platforms are not in it. Searching all 422 names for the largest owners returns nothing: not Inception, not Prelude, not Pinnacle, not US Fertility, which owns Shady Grove and appears nowhere. Clinics those platforms acquire typically keep their local branding.

So a bucket labeled "independent" would quietly contain PE-owned practices, and the comparison would be wrong in a direction nobody could measure. We would rather publish the narrower question we can answer. That opacity is itself the finding for a patient: you cannot tell who owns your clinic from any public record we can reach.

Download the dataset (CSV) · How the composite score works

Source: CDC NASS 2022 Final ART Summary, the same federal filing behind every clinic page here. Brand membership is determined by clinic name and verified clinic by clinic; a shared generic phrase is not a brand. Free to cite with attribution.