Fertility Clinics & Adoption Services: An Industry Analysis

(September 2000)


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Table of Contents






* Report Scope & Methodology, sources used, survey letter and questionnaire                       1-6


Executive Overview of Major Findings                                                                                     7-28


* Summary of combined industry revenues and industry snapshot, comparative growth rates, Highlights of all study chapters. Adoption services: how they operate, fees, licensing and regulation, demand for their services, operating ratios, industry size & segments (1975-2004F), intl. Vs. US adoptions, major industry trends and issues, adoptive parent and adopted children demographics, list of top 21 US adoption agencies. Analysis of fertility treatment services industry: nature of the field, no. of ART clinics, how patients pay/insurance, treatment methods (diagnostic, therapeutic approaches, no. of procedures performed per year and cost), infertile customer demographics, results of Marketdata custom survey on fertility clinic operating ratios, industry size/growth/segments (1988, 1995, 1999, 2000, 2004F -- $ value of: MD consults, semen & hormone evaluations, lap & dye, tubal surgeries, IVF and GIFT procedures, fertility drugs mkt.), discussion of rationale for future growth, list of top 4 competitors.


The Adoption Services Industry                                                                                               29-68


* Summary & nature of the adoption process: how agencies work, problems faced by

   adoptive parents, fees, discussion of data collected by Natl. Council For Adoption, industry 

   structure (no. of agencies by kind, attorneys), how agencies are formed, trade associations

   that exist.

* No. of adoptions in the US (intl., special needs, healthy baby, related adoptions, etc.)

* Agency operating ratios (avg. annual receipts, start-up funds needed, labor costs, profit


* Industry Size & Growth: estimates of $ value of 4 main segments (intl. adoptions, special 

   needs children, US healthy babies, US older children – 1999)

   Table: No. of unrelated adoptions, by kind (1975-2000)

   Table: $ value of industry receipts, by segment/type adoption (1975-2004F)

* Discussion of Hague Treaty signing, role of State Dept., effect on growth in adoptions

* Future trends – 5-year Outlook: effects of 1997 Adoption & safe Families Act, foster care

    system, 10 major trends identified by NCFA.




The Adoption Services Industry (continued)                                                                            Page


* Customer Demographics: Summary & discussion of trends in adoptions in the U.S.,

   percentages of unrelated domestic adoptions, national trends in adoption, intercountry

   adoptions to the US  1997, etc., profile of adoptive Parents (age, income, race), profile of

   children up for adoption, no. of people that want to adopt, NCFA data for 1992-1996

   (domestic, unrelated, related adoptions trends)

* Intercountry adoptions discussion, table: no. of  intercountry adoptions 1973-1997



- Number of visas issued to orphans to be adopted in the U.S. by the Department

     of State And INS (1996-98)

- National estimates of related and  unrelated adoptions: United States: 1951–1996

- National estimates of unrelated adoptions and type of agency making adoptive

    placement: United States 1951-1996

- Immigrant-orphans adopted by US Citizens by selected country of birth: 1990-1997

- Immigrant orphans adopted by united states citizens by age, sex, and state of intended



Major Adoption Agency Profiles

In-depth descriptions of…

-               Spence-Chapin

-               Bethany Christian Services

-               Wide Horizons For Children

-               Frank Adoption center

-               European Adoption Consultants

-               Christian World Adoption

-               World Assn. For Children & Parents


* Ranking of the Top 21 Agencies in the U.S. (1999 number of adoptions, estimated revenues)


General Adoption Statistical Tables (NCFA, NAIC)

-               Filing trends in adoption, by state and type court: 1988-1997

-               Trends in public agency, private agency, individual domestic adoptions (1982-1996)

-               Related & unrel. domestic adoptions, intercountry, by state (1996)

-               No. of domestic infant adoptions, abortions, live births, ratios, by state (1996)

-               No. and % distribution of types of unrelated domestic adoptions, by state (1996)

-               Special needs adoptions as % unrelated domestic adoptions, by state (1992, 1996)

-               Finalized adoptions from foster care, by state (FY 1998)









The Fertility Clinics Industry                                                                                                 69-107


* Nature and Definition of the field: no. of clinics, OB/GYNs involved, estimates of mkt. size

   by various sources, assisted reproductive technology (ART) techniques and why becoming 

   more popular, insurance coverage, typical fees for treatment, new financing options being


*  Discussion of causes of Infertility

*  Treatment Methods Used: analysis & discussion of Diagnostic approaches (HSGs, no. and

    cost),  Therapeutic approaches (tubal surgery, IVF procedure, GIFT  procedure, no. of and

    costs), genetic testing.


Infertile Customer Demographics

* Infertile Couples - number of, analysis of needs


Fertility Clinic Business Operating Ratios: Results of custom Marketdata survey

(Aug. 2000)                                                                                                                                           76

-               Location (MD practice vs. hospital, %)

-               Title of Lab Director (MD, PhD)

-               Full-time staff (clinical, admin. Laboratory)

-               Starting salaries for clinic job functions (embryologist, lab director, HCL director,

          LPN, RN, lab technician)

-               Annual Patient volume for: new patient visits, IUIs, surgical procedure, retrievals

-               Prices charged for services (see above, plus semen analysis, ultrasound,
pkg. Price for IVF -  % by price ranges)

-               Percent of revenues paid by insurance

-               Most important issues for clinics over next three years.


Industry Size, Structure and Growth                                                                                                   80

* Summary and Analysis, Industry Trends

   Table: Size of fertility services industry – 1999: diagnostic & therapeutic procedures (no.

              performed, avg. cost, estd. $ value)

* Discussion of no. of ART clinics 1985-2000, avg. revenues, value of this segment

* Discussion of fertility drug mkt., drug sales by brand name (gonadotrophins, 1995-1999)

   Table: Estimated historical size of mkt., by segment: 1988, 1995, 2000

   Table: National $ Revenues for 2000, 2004 forecasts.


Major Competitor Profiles                                                                                                                 85

-               Resolve

-               Allan Guttmacher Institute

-               Genetics and IVF Institute

-               IntegraMed America, Inc.




The Fertility Clinics Industry (continued)                                                                               Page



* Surrogate Parenting: Discussion of the need for it, mkt. size, fees, etc.                               91



-               No. of women receiving fertility services, by selected characteristics (1995)

-               Childless women and children ever born, by race, age, marital status (1998)

-               Total US fertility rate (1960-1997), projected rates by age group (to 2010)


Major Findings of 1997 CDC Survey on Assisted Reproductive Technology (ART)              96

* 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, male factors, tables and charts, etc.


Directory of 330+ Fertility Clinics in the U.S.                                                                              108-144

* Name, address, phone, fax


Industry Reference Directory

* List of adoption and fertility services industry trade groups, associations,

   surveys, consultants, and other sources.                                                                                      145