The Subversive Influence of Outside Capital Even Reaches into Medical and Science Publications
Our lack of enthusiasm for the overwhelming flood of “opinion” articles, often now exceeding real science pages in Fertility and Sterility (and in other journals), is by now well known. They come in all kinds of publication formats from reviews (it seems journals are constantly inventing new review formats or at least giving them new names), such as Views, Inklings, etc., thereby stealing valuable publication spaces for real articles. But these kinds of opinion articles are more frequently cited than science articles and, therefore, improve a journal’s citation index. Consequently, everybody is doing it, more or less!
F&S—no doubt—has mastered the process and, therefore, has greatly improved its impact factor (2024, 11.6) and—in doing so—has been far exceeding its perpetual competition, Human Reproduction (HR) (2024, 6.2), even though the highest impact factor in the field is owned by Human Reproduction Update (2024, 16.1), of course a review journal (but a good one!).
Why are we addressing this here? Because medical journals are businesses and, often, they are very important businesses for their owners, frequently medical societies (like F&S and HR), and these societies also “have to make an economic living” in order to maintain their ever-growing bureaucracy. And that, of course, depends to a significant degree not on membership fees (though they, of course, are also important) but on advertisers, sponsors, exhibitors, donations, etc. And like anywhere else in society, with money comes influence.
We, of course, have gotten used to it, and – at least the smarter ones have learned to read between the lines. But sometimes things are getting too silly, and somebody must speak out. Here is one such example: Unsurprisingly an Inkling article in F&S by two authors who are telling us how wonderful it is to be part of US Fertility, which describes itself as “the largest physician-led fertility network,”¹ and includes Fertility Centers of Illinois, IVF Florida, Ovation Fertility, RMA of New York, RSC Bay Area, and, of course, the mothership, Shady Grove Infertility.
As the authors noted, it may “not be a golden ticket (not many of those around these days) but a way to get to our destination.”²
The paper raises the issue of what the intended destination is.
Operating under new ownership every 5 to 7 years, if one is lucky (ask Boston IVF; in their case, it happened even more frequently). Being told how many patients you have to start in an IVF cycle every week or month, and how many among those must be more income-producing donor-recipient cycles. Or not being allowed to treat women above 43 in autologous cycles because they, of course, belong in a more revenue-producing donor egg cycle. And just to make sure, even if supposedly “physician led” (and which fertility clinic is on paper not “physician-led”), it is, of course, the law in most states. Corporations are not allowed to practice medicine, though many, of course, to varying degrees do exactly that (see also elsewhere in this issue the article on insurance companies practicing medicine).
But enough of that, and back to the F&S paper. Why was it even written, and why was it accepted for publication (or was it, by any chance, even invited)? What is the benefit of this paper to any reader?
It obviously offers a skewed view. At least one of the authors is employed by one of the clinics under US Federal management (and seriously claims to have “no conflict” in his disclosure, and the editors let it pass)
And then comes the gaslighting: The authors really try to sell us on the notion that US Fertility programs “training 30 REI fellows across the U.S.” is a good thing for the infertility field (we, for several reasons, would argue exactly the opposite). But it then gets even more bizarre, the authors expressed their pride about US Fertility physicians in 2024 having published a whopping 74 peer-reviewed publications.
Was this a joke? Apparently not, they really meant it!
US Fertility is alleged to employ over 200 reproductive endocrinologists and urologists (and God only knows how many PhDs). The 74 peer-reviewed published articles in 2024, therefore, come to exactly 0.37 peer-reviewed papers per employed physician, not even including all the PhDs in their many labs.
Seriously? A physician who produces fewer than 0.37 peer-reviewed publications annually at the CHR would likely not even survive a first year of employment.
In short, not only did F&S waste two valuable pages of journal space on a useless paper that doesn’t tell anybody anything of importance, but the paper (or should we say the authors), on top of it, abused the opportunity for trying to gaslight the readership. Whether, and if so, to what degree they succeeded with is, of course, difficult to know, but this publication, of course, raises the very obvious question whether the fact that this paper was accepted for publication is evidence for the increasing influence of “industry” (and a company like US fertility now must be viewed as part of industry) on what is published in the fertility field.
And within such a context, it, of course, is of considerable relevance, and would have been of some significance, one can assume, for readers of the F&S article, that Amulet Capital Partners (the majority stockholder in US Fertility) for quite some time had been trying to sell the company. On Analytics in August of 2025, indeed, reported that US Fertility was in the second round of a sale process and being marketed at a US$175m EBITDA.³
But things apparently didn’t work out as planned for Amulet Capital Partners because they, seemingly, had to change their initial strategy of simply selling their majority share in US Fertility. According to an article by Ron Shinkman in Inside Reproductive Health,⁴ US Fertility (i.e., Amulet Capital Partners) instead entered into a new strategic partnership with a second private equity firm intended to fuel the ongoing expansion of US Fertility with additional investment capital. This second equity firm is the Maryland-based L Catterton, which bought a 42.5% stake in US Fertility, representing half of Amulet’s ownership in US Fertility. Amulet and Catterton are, therefore, now described as co-lead investors. Moreover, physicians and management, therefore, own only the remaining approximately 15% of the company.
Is this what can be described as a physician-led company? We don’t think so, but can’t wait to see what comes next! Maybe an article in F&S telling us how great this sale of control at UF Fertility really was?
References
US Fertility. https://www.usfertility.com/ Accessed December 18, 2025
Boedeker D, Widra E. Fertil Steril 2025;124(5P2):962-963
Martinez C. On Analytics. August 13, 2025. https://ionanalytics.com/insights/mergermarket/us-fertility-in-second-round-of-sale-process/
Shinkman R. Inside Reproductive Health. December 11, 2025. https://www.fertilitybridge.com/news-articles/us-fertility-l-catterton-investment