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70% of fertility clinics don’t show up when AI is asked for the best in their city

We asked an AI answer engine the single question a new customer asks first — “best fertility clinic in {their city}” — for 71 real fertility clinics across 25 metros. 50 of them were never recommended.

What we found

We took 71 fertility clinics we’d already identified across 25 U.S. metros and asked Perplexity the highest-intent question a prospective customer asks: “best fertility clinic in {city}”, using each business’s own city. We recorded whether the engine recommended the business.

50 of 71 (70%) were not recommended at all — invisible to AI for the exact search that sends the most ready-to-buy customers. Each of those is a high-intent customer the AI handed to a competitor instead.

Fertility clinics checked71
Metros25
Not recommended by AI50 (70%)
Question asked“best fertility clinic in (their city)”
EnginePerplexity
Checked2026-07-17

City-by-city results — who AI recommends and who never came up — are in the AI visibility index for fertility clinics.

How we did it (so you can repeat it)

No survey, no estimate. We ran the same automated AI Visibility Check we offer for free, once per business, against a real sample spread across metros so the number isn’t a quirk of one city. The businesses checked were the top local results on Google Maps — already-winning businesses, which makes the number conservative. Anyone can re-run “best fertility clinic in [city]” and see who gets recommended.

This audit reflects what public AI answer engines returned for these buyer questions on the date shown. AI answers are non-deterministic and change over time; this is a point-in-time visibility snapshot, not a guarantee of ranking. We checked one engine for the category question on the date shown; results shift over time, so this is a point-in-time snapshot, not a fixed ranking. We publish the method and the date precisely so it can be checked.

Why this happens

It’s rarely about quality. AI recommends the businesses it has the clearest, most consistent, most-talked-about information on. A great fertility clinic with thin reviews, inconsistent listings, or no mentions in the local “best of” lists simply isn’t in the data the model trusts — so it plays safe and recommends someone else. Here’s the full mechanic.

Want to know which side of this number your business is on?

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