Enquirer Consulting Group

Reachable Buyer Map

Prepared for Louis Villalba · TMRW Life Sciences · August 2026
This is a market you can count. Fertility clinics in the United States number in the hundreds, not the thousands, and every one of them can be named. That changes what an outbound channel is for. It stops being a volume problem and becomes a coverage problem: which of the few hundred accounts has had a real conversation this quarter, and which seat inside them answered.
Fertility clinics reporting nationally
The core of the market and the whole of it at the same time. Every clinic providing assisted reproductive technology reports outcome data under a federal requirement, which means the base is public, stable and countable.
Who signs: the laboratory director, the embryology supervisor, the medical director, and the practice administrator.
450 to 500
US clinics providing ART and reporting outcomes; a small share do not report and sit outside this count
Network-owned clinic groups
The layer that changed the market. Affiliation with investor-backed networks moved from a small minority of clinics to roughly a third inside a decade, and those clinics run more than half of national cycle volume.
Who signs: the network chief operating officer, the VP of laboratory operations, the director of quality, and central procurement.
About a third of clinics, over half the cycles
network affiliation rose from roughly 4 percent of clinics in 2013 to roughly 32 percent in 2023; affiliated clinics performed the majority of cycles in the most recent published year
Hospital and university programs
Same laboratory work, completely different buying path. Institutional procurement, capital committees and an academic calendar, so the decision moves on an annual cycle rather than a quarterly one.
Who signs: the laboratory director, the division chief, and institutional procurement or the capital committee.
A minority of the clinic base
academically housed programs are not enumerated separately from their host institution in the national clinic data
Donor gamete banks
The clearest consolidation story in the field. The number of banks fell sharply over three decades while the donor pool held roughly steady, so volume per remaining bank has risen and so has the cost of a storage failure.
Who signs: the laboratory director, the operations lead, and the founder or general manager.
14 to 16
sperm banks operating nationally, down from roughly 29 in 1996; egg banking is often run inside the same operators and is not counted separately
Fertility preservation programs
Preservation for oncology and for medical necessity sits inside health systems rather than in standalone clinics, so it is invisible to any list built from the clinic register.
Who signs: the laboratory director, the oncology service line lead, and the health system supply chain seat.
No separate register
preservation programs are recorded under their host institution; they are reached by name, one program at a time
The seat count behind the account count
The number that reframes the channel. A few hundred organizations, but four or five decision seats inside each one, and they do not agree with each other about what the problem is.
Who signs: laboratory, medical, administrative and, at the networks, operations and quality.
1,800 to 2,500
named decision seats derived from the reporting clinic base at four to five per clinic; a derived figure, not a separately published one

Where the openings are

1
Half the volume now sits behind a few dozen doors. Network affiliation went from a small minority of clinics to about a third in ten years, and those clinics run most of the cycles. One conversation at a network covers many laboratories at once. The other half of the market is several hundred independent clinics where the laboratory director decides alone. Those are two different channels and most vendors run only one of them.
2
The person who carries the risk is not the person who signs. The embryologist lives with the consequence of a mislabeled or lost specimen. The administrator or the network finance seat signs for the fix. Reaching one and not the other explains most evaluations that stall after a good first meeting.
3
A countable market rewards coverage, not volume. With a few hundred named accounts, the honest measure is not how many messages went out. It is what share of the named base has had a real conversation in the last two quarters, and which seat inside each one. That is a tracking discipline more than a sending one, and it is the part that is usually missing.
4
Consolidation is a clock, and it is visible from outside. Ownership changes, network additions and laboratory director moves all reopen decisions that were closed. Watching a few hundred named accounts for those events is mechanical work that a channel can do continuously. Hearing about them at a conference is the alternative, and it is always late.
Built from public federal registries and published sector reporting on assisted reproductive technology, current to the most recent published year. Counts are banded deliberately. Clinic figures describe reporting organizations rather than physical sites, and a small share of clinics do not report. The seat count is derived from the clinic base rather than separately published. It describes the market rather than your business, and there is nothing to buy at the end of it.
ENQUIRER CONSULTING GROUP
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