Journal of Assisted Reproduction and Genetics

, Volume 36, Issue 2, pp 283–289 | Cite as

Business models and provider satisfaction in in vitro fertilization centers in the USA

  • J. E. McLaughlinEmail author
  • J. F. Knudtson
  • R. S. Schenken
  • N. S. Ketchum
  • J. A. Gelfond
  • T. A. Chang
  • R. D. Robinson
Assisted Reproduction Technologies



The number of in vitro fertilization (IVF) cycles is increasing and the majority of patients undergoing IVF pay out of pocket. Reproductive endocrinology and infertility practitioners employ different business models to help create financial pathways for patients needing IVF but details regarding the different types of business models being used and physician satisfaction with those models have not been described previously.


A cross-sectional survey was sent to members of the Society of Reproductive Endocrinology and Infertility. The survey included 30 questions designed to assess demographics, practice patterns, and business models utilized.


A total of 222/736 (30%) physicians responded to the survey. The majority of physicians offer a-la-carte (67%), bundled services (69%), grants (57%), and cost/risk-sharing (50%). The majority answered that the single ideal business model is bundled services (53%). There was no significant association between financial package offered and region of practice or state-mandated insurance. The largest barrier to care reported was cost with or without state-mandated coverage (94% and 99%, respectively). The majority of practices are satisfied with their business model (75%). Higher physician satisfaction was associated with private practice [69% vs 27%; OR (95%CI) = 3.8 (1.7, 8.6)], male gender [59% vs 30%; OR = 2.4 (1.1, 5.4)], and offering bundled services [83% vs 59%; OR = 2.8 (1.2, 6.7)].


Physicians utilize a variety of business models and most are satisfied with their current model. Cost is the major barrier to care in states with and without mandated coverage.


In vitro fertilization Business models Physician satisfaction Barriers 



The project was also supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant KL2 TR001118 (JFK). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.


The project described was supported by the 2016 Vivere Scientific Advisory Board Research Grant (JEM).

Compliance with ethical standards

This article does not contain any studies with human participants or animals performed by any of the authors.

Conflicts of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • J. E. McLaughlin
    • 1
    Email author
  • J. F. Knudtson
    • 1
  • R. S. Schenken
    • 1
  • N. S. Ketchum
    • 2
  • J. A. Gelfond
    • 2
  • T. A. Chang
    • 1
  • R. D. Robinson
    • 1
  1. 1.Obstetrics and GynecologyUniversity of Texas Health Science Center at San AntonioSan AntonioUSA
  2. 2.Epidemiology and BiostatisticsUniversity of Texas Health Science Center at San AntonioSan AntonioUSA

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