Southwest U.S. Fertility Clinic, 25-Year Reproductive Endocrinology Practice

$2.1M

Revenue

$900K

SDE

Subscribe Free

Read the full deal writeup

Get Free Access

Already a member? Sign in

Full Editorial Writeup

This is a full-service fertility clinic in the Southwest U.S. with more than 25 years of operating history, providing reproductive endocrinology services out of an approximately 2,800-square-foot facility. The build-out is purpose-fit for the specialty: three ultrasound rooms, a surgical suite, cryogenic storage, blood and sterile labs, and in-house embryology and andrology labs. The service menu covers IVF, IUI, egg donation, ICSI, genetic testing, egg freezing, tubal reversal and reproductive surgery, which is a high-value, high-margin clinical mix.

The clinic runs on approximately $2.146 million in collections with roughly $405,000 adjusted EBITDA and $900,000 in owner cash flow. It generated about 425 new patient consultations in the last twelve months and carries a payer mix of roughly 70% insurance and 30% cash. Notably, the practice does zero paid advertising, which means the current volume is essentially organic and referral-driven.

The owner-doctor is open to a range of exits: a sale to an individual physician, a partnership, or a bolt-on to a regional platform or fertility organization. Because this is a medical practice, buyers must be licensed physicians or have a legally compliant PC/MSO structure in place. The real estate is owned and available separately in connection with the transition.

Why we like it

Fertility care is one of the most durable, cash-generative niches in healthcare, with a mix of IVF, egg freezing and genetic testing that carries premium pricing and strong margins. At roughly $2.146 million in collections producing $900,000 of owner cash flow, this practice is converting close to 42 cents of every collection dollar into owner earnings before any optimization.
The moat here is real and hard to replicate: 25 years of operating history, a full-service embryology and andrology lab, cryogenic storage and a surgical suite already built out. Recreating this facility and the clinical reputation from scratch would take years and significant capital, and the licensing requirement to own a fertility practice keeps out casual competition.
Demand for fertility services is structurally growing as people delay childbearing and awareness of IVF and egg freezing rises, and a meaningful share of the payer mix is now insurance covered as more employers add fertility benefits. This clinic already sits at 70% insurance, which stabilizes collections versus a pure cash-pay model exposed to discretionary spend.
The operator upside is unusually clean: the practice does no paid advertising at all and still books roughly 425 new patient consultations a year. An operator who layers in digital marketing, referral relationships and a modern intake funnel can grow cycle volume without adding a single new exam room.

How to improve it

Launch a basic digital marketing program in the first 90 days, since the clinic currently spends nothing on paid acquisition. A focused local SEO, paid search and physician-referral campaign in a growing fertility market could meaningfully lift the 425 annual consults toward higher cycle volumes.
Optimize the payer and pricing mix by auditing insurance contracts and cash-pay bundle pricing. With 70% insurance and 30% cash, renegotiating carrier reimbursement rates and packaging cash-pay IVF and egg-freezing offerings can widen the gap between the $405,000 adjusted EBITDA and the $900,000 cash flow.
Increase cryogenic storage recurring revenue by aggressively marketing egg and embryo freezing with annual storage fees. This creates a sticky, high-margin annuity stream layered on top of one-time procedure revenue, improving both earnings quality and multiple at exit.
Add or extend physician and embryology lab capacity to reduce wait times and capture cycle demand the clinic may be turning away. Since the specialty is supply-constrained on clinical staff, hiring a second RE or advanced practice provider could unlock volume the existing three ultrasound rooms can support.
Formalize employer and benefits-manager relationships to funnel covered fertility patients directly to the clinic. As more employers add fertility benefits, becoming a preferred in-network provider for local employers and TPAs is a low-cost way to grow insured patient flow.
Systematize the practice for a manager-run model so the business is less dependent on the founding owner-doctor. Documenting clinical protocols, building a strong practice administrator role and cross-training lab staff makes the asset transferable and materially more valuable to a platform buyer.

Diligence notes

Reconcile the earnings figures: the listing shows $900,000 cash flow (SDE), $405,000 adjusted EBITDA, and $2.146 million collections. Understand exactly what add-backs bridge EBITDA to SDE, how much is true owner compensation versus a market-rate physician salary, and whether the buyer must replace the owner-doctor's clinical production.
Quantify the clinical dependency on the founding physician, since fertility volume often follows a specific RE's reputation and referral network. Confirm whether a new or employed physician can retain patient flow and referrals, and negotiate a meaningful transition and non-compete to protect the goodwill.
Verify the payer mix and reimbursement durability by reviewing actual insurance contracts, denial rates, and collection cycles behind the stated 70/30 split. Confirm there is no single carrier or self-funded employer concentration that could drop coverage and swing collections.
Investigate the real estate separately, since the 2,800-square-foot facility is owned and offered apart from the practice. Get an independent valuation and lease terms, because specialized lab and surgical build-out limits alternative uses and affects both purchase economics and future rent as an expense line.
Confirm the licensing and corporate practice-of-medicine structure required to legally own this clinic in its state. Buyers who are not physicians need a compliant MSO or PC arrangement in place before diligence, and the timeline and cost of that structure should be scoped early.
Assess lab equipment condition, cryogenic storage inventory, and any liability tied to stored eggs and embryos. Aging embryology equipment, storage tank maintenance obligations, and consent documentation for stored specimens are material risks unique to this specialty.

Source

Originally listed on BizBuySell. View original listing →