Guide to Selling a Fertility & IVF Practice in New Hampshire

The U.S. fertility market is experiencing significant growth, and New Hampshire is no exception. For owners of Fertility and IVF practices, this creates a unique window of opportunity. However, turning that opportunity into a successful exit requires more than just a growing market. It requires strategic preparation. This guide gives you a clear overview of the current landscape for selling a fertility practice in the Granite State, from market trends to valuation and the key steps you need to consider for a successful transition.

Market Overview

The decision to sell your practice doesn’t happen in a vacuum. It is heavily influenced by market conditions. Right now, the conditions for fertility practices are strong.

National Growth Reaches the Granite State

The fertility industry is seeing record demand across the country. This is driven by delayed parenthood, greater social acceptance, and remarkable clinical advancements. This national attention means buyers, including large strategic groups and private equity investors, are looking for well-run practices everywhere, not just in major metro areas. A successful New Hampshire practice with a strong reputation is more valuable than ever. However, you must navigate New Hampshire’s specific regulations for medical practice sales, which require careful handling, especially for a specialized field like IVF.

The Buyer Landscape is Evolving

The interested buyer for your practice today is likely very different from who it was five or ten years ago. It may not be another local physician. Instead, it could be a regional health system looking to add a fertility service line or a national fertility platform seeking a foothold in New England. These are sophisticated buyers. They analyze practices differently, and they expect a professional and organized sale process. Understanding their perspective is key to positioning your practice effectively.

Key Considerations

When a potential buyer looks at your New Hampshire fertility practice, they see more than just a building and equipment. They are evaluating the business’s health and future potential. Here are three areas they will scrutinize.

1. Your Financial Story. Buyers look past your top-line revenue. They want to understand your profitability. We find the most important metric is Adjusted EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization). This figure normalizes your profits by adding back owner-specific expenses. Presenting a clear, defensible Adjusted EBITDA is the foundation of a strong valuation.
2. Your Clinical Reputation. In the world of fertility, reputation is paramount. Buyers will look at your success rates, patient testimonials, and referral patterns from other physicians. Having this data well-documented is not just good practice. It’s a critical marketing asset during a sale.
3. Your Operational Dependencies. Is the practice’s success tied entirely to you, the owner? Practices with diversified provider teams, established operational systems, and a stable staff are inherently less risky for a buyer. They command higher valuations. If you are central to every part of the practice, it’s a risk a buyer must factor in.

Market Activity

The fertility and IVF sector is a hotbed of transactional activity. This is not driven by chance. It is a calculated push by well-funded groups to consolidate a fragmented market. For a practice owner in New Hampshire, this presents both a challenge and a significant opportunity.

The Rise of Strategic Partnerships

Private equity firms and large fertility networks are actively acquiring practices to build regional and national platforms. They are not looking for “fixer-uppers.” They seek profitable, well-managed practices that can serve as a foundation for further growth. They are often willing to pay a premium for these “platform” practices. A partnership with such a group can provide capital for expansion and technology, but it requires a different kind of negotiation. They focus on growth potential, and you need to tell that story with credible data.

Why Preparation is Your Best Advantage

These sophisticated buyers have teams of experts. They have done this many times before. Entering a conversation with them unprepared is like showing up to a final exam without studying. They will control the process and the narrative. By preparing your practice for sale well in advance, you level the playing field. You can run a competitive process that creates multiple options, giving you the leverage to choose the right partner and the right deal structure for your future.

Sale Process

Selling a medical practice is a structured process, not a single event. While every deal is unique, the journey generally follows a clear path. Knowing these steps helps you prepare for what’s ahead.

1. Preparation and Valuation. This is the foundational stage. It involves gathering your financial and operational documents and getting a professional valuation to understand what your practice is worth in the current market.
2. Confidential Marketing. Your advisor will create a compelling, anonymous profile of your practice and present it to a curated list of qualified buyers, protecting your identity and preventing disruption to your staff and patients.
3. Negotiation and Letter of Intent (LOI). After initial discussions, interested buyers will submit offers. We help you compare them not just on price, but on terms and structure. Once you select the best offer, you sign a non-binding LOI.
4. Due Diligence. This is the most intensive phase. The buyer will conduct a deep-dive investigation into your financials, operations, and legal compliance. Many deals fail here due to poor preparation. A clean, organized practice sails through. A messy one raises red flags.
5. Closing. Once due diligence is complete, lawyers draft the definitive purchase agreements. After a final review, the documents are signed, funds are transferred, and the practice officially transitions to its new owner.

Valuation

How much is your New Hampshire fertility practice worth? The answer is more complex than a simple multiple of your annual revenue. Sophisticated buyers value your practice based on its normalized cash flow, or Adjusted EBITDA. This figure represents the true earning potential of the business for a new owner.

It starts with your net income, then adds back expenses that a new owner would not incur. This includes things like your personal salary above a fair market rate, one-time legal fees, or other personal expenses run through the business. A higher Adjusted EBITDA leads directly to a higher valuation. We see many practice owners who think their practice has low value, only to discover its true potential after a proper analysis.

Here is a simplified example of how this works for a practice with $400,000 in net income.

This Adjusted EBITDA figure is then multiplied by a factor based on market conditions, your practice’s size, and its growth prospects to determine the final enterprise value.

Post-Sale Considerations

A successful sale is about more than the final price. It is about ensuring a smooth transition for your legacy, your staff, and your own next chapter. Planning for what happens after you sign the papers is a critical part of the process itself.

1. Protecting Your Team and Legacy. You have spent years building a dedicated team and a trusted reputation in your community. A good deal structure includes provisions to protect your staff and ensure the clinical culture you built continues to thrive under new ownership.
2. Structuring Your Payout. The structure of your sale has major implications for your after-tax proceeds. Decisions about how much cash you receive at closing versus what might be in an earnout (future payments based on performance) or rollover equity (retaining ownership in the new, larger company) require careful thought. These decisions can dramatically impact your final net wealth.
3. Your Role After the Sale. Do you want to walk away completely, or do you want to continue practicing clinically for a few more years without the stress of management? Defining your desired role early in the process is key. It allows us to find a buyer whose vision aligns with your personal and professional goals, ensuring your transition out of ownership is on your terms.