Patrick Steptoe and Robert Edwards were responsible for the birth of the world’s 1st IVF baby, Louise Brown, in 1978. Since then about 4 million babies have been born worldwide, and the number is growing fast. The introduction of this Assisted Reproductive technology (ART) which comprises IVF and associated procedure has literally revolutionized the treatment of infertility and Reproductive failure but has also spawned religious and social controversy.
In 2011, in the United States, the infertility services market was about $3.5 million. This number has been growing by an estimated rate of 4% per year such that in 2015 it is likely to be closer to $4.0 billion. ART comprises about one half of this overall Infertility Services market. It is made up of about 500 ART medical centers, > 100 sperm banks (worth about $90,000,000 annually) as well as a fast growing number of egg banks and third party parenting (egg donor and gestational surrogacy) agencies. In addition, there are currently several large companies that market pharmaceuticals products, used in the treatment of infertility and is worth more than $500,000,000 annually. Currently, ART is serviced by about 2,000 fertility physicians in this country.
The number of IVF cycles performed in the U.S.A has grown from 70,000 in 1997 to almost 170,000 in 2014 and is projected to be about 185,000 by 2018. While at first glance this suggests growing access to IVF in this country it nevertheless meets <20% of the need (which presently is for 1.0 million procedures per year). This large discrepancy between supply and demand for IVF services, is largely because IVF, an elective procedures is unaffordable to most who need access. The fact is that currently, fewer than 50% of patients who have medical insurance, are being covered for ART service. And, the high cost of $10,000-$20,000 cost per procedure puts it outside the reach of most. I consider it to be a profound embarrassment that when compared to other 1st world countries, the United States ranks lowest in the world when it comes to servicing the ART needs of its population.
Most IVF clinics in the United States are small or intermediate in size practices and operate independently or form part of a hospital or University. Such clinics generate on average $2.0-$4.0 million annually. The ART industry in the United States, has spawned several large conglomerates that function as “corporate networks”. The largest of these is IntegraMed, a private company that currently owns or manages 20-25% of the IVF clinics in the United States and which also recently acquired the Sher Institutes for Reproductive Medicine (SIRM).
In the United Stated, ART is an unregulated industry. It is overseen by the American Society for Reproductive Medicine (ASRM) and its subsidiary, The Society for Assisted Reproductive Technology (SART). Unsupervised, non-audited, IVF outcome statistics are self-reported by clinics to SART and/or to the Centers for Disease Control (CDC) annually.