INTEGRAMED AMERICA INC
10-Q, 1999-11-15
OFFICES & CLINICS OF DOCTORS OF MEDICINE
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================================================================================

                                  UNITED STATES
                       SECURITIES AND EXCHANGE COMMISSION

                             WASHINGTON, D.C. 20549
                            ------------------------

                                    FORM 10-Q

              [X] QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d)
                     OF THE SECURITIES EXCHANGE ACT OF 1934

                For the quarterly period ended September 30, 1999

                                       OR

             [ ] TRANSITION REPORT PURSUANT TO SECTION 13 OR 15 (d)
                     OF THE SECURITIES EXCHANGE ACT OF 1934

                        For the transition period from to

                           Commission File No. 0-20260
                           Commission File No. 1-11440

                            INTEGRAMED AMERICA, INC.
             (Exact name of Registrant as specified in its charter)


          Delaware                                      06-1150326
(State or other jurisdiction               (I.R.S. employer identification no.)
of incorporation or organization)

       One Manhattanville Road                             10577
         Purchase, New York                              (Zip code)
(Address of principal executive offices)


                               (914) 253-8000
            (Registrant's telephone number, including area code)


         Indicate by check mark whether the Registrant (1) has filed all reports
required to be filed by Section 13 or 15(d) of the  Securities  Exchange  Act of
1934  during  the  preceding  12 months  (or for such  shorter  period  that the
Registrant was required to file such reports),  and (2) has been subject to such
filing requirements for the past 90 days.

                            Yes [X]       No [   ]

         The aggregate number of shares of the Registrant's  Common Stock,  $.01
par value, outstanding on November 1, 1999 was 4,791,860.


================================================================================

<PAGE>



                            INTEGRAMED AMERICA, INC.
                                    FORM 10-Q
                                TABLE OF CONTENTS


                                                                        Page No.
                                                                        --------

PART I  -  FINANCIAL INFORMATION

   Item 1.   Financial Statements

               Consolidated Balance Sheet at September 30, 1999 (unaudited)
                and December 31, 1998........................................ 3

               Consolidated Statement of Operations for the three and
                nine-month periods ended September 30, 1999
                and 1998 (unaudited)......................................... 4

               Consolidated Statement of Cash Flows for the nine-month
                periods ended September 30, 1999 and 1998 (unaudited)........ 5

               Notes to Consolidated Financial Statements (unaudited)...... 6-7

   Item 2.   Management's Discussion and Analysis of Financial Condition
                and Results of Operations..................................8-12

   Item 3.   Quantitative and Qualitative Disclosures about Market Risk....  12


PART II  -   OTHER INFORMATION

   Item 1.   Legal Proceedings.............................................  13

   Item 2.   Changes in Securities.........................................  13

   Item 3.   Defaults upon Senior Securities...............................  13

   Item 4.   Submission of Matters to a Vote of Security Holders...........  13

   Item 5.   Other Information.............................................  13

   Item 6.   Exhibits and Reports on Form 8-K..............................  13


SIGNATURES  ...............................................................  14

INDEX TO EXHIBITS       ...................................................  15

                                        2
<PAGE>


PART I -- FINANCIAL INFORMATION

     Item 1.    Consolidated Financial Statements
<TABLE>

                            INTEGRAMED AMERICA, INC.
                           CONSOLIDATED BALANCE SHEET
         (all amounts in thousands, except share and per share amounts)
<CAPTION>


                                                                                  September 30,   December 31,
                                                                                  ------------    -----------
                                                                                      1999           1998
                                                                                  ------------    -----------
                                                                                   (unaudited)
Current  assets:
<S>                                                                                 <C>            <C>
   Cash and cash equivalents.....................................................   $ 3,882        $ 4,241
   Patient accounts receivable, less allowance for doubtful accounts
     of $ 731 and $526 in 1999 and 1998, respectively............................    10,472         10,749
   Management fees receivable, less allowance for doubtful accounts
     of $0 and $305 in 1999 and 1998, respectively...............................       993          1,963
   Other current assets..........................................................     1,169          1,736
                                                                                    -------        -------
       Total current assets......................................................    16,516         18,689
                                                                                    -------        -------
   Fixed assets, net.............................................................     6,388          5,116
   Intangible assets, net........................................................    19,600         19,269
   Other assets..................................................................       322            619
                                                                                    -------        -------
       Total assets..............................................................   $42,826        $43,693
                                                                                    =======        =======

                      LIABILITIES AND SHAREHOLDERS' EQUITY

Current liabilities:
   Accounts payable..............................................................   $   588        $   684
   Accrued liabilities...........................................................     4,516          3,480
   Due to Medical Practices......................................................     1,385          1,877
   Current portion of long-term notes payable and other obligations..............     1,275          2,099
   Patient deposits..............................................................     2,010          2,888
                                                                                    -------        -------
       Total current liabilities.................................................     9,774         11,028
                                                                                    -------        -------
Long-term notes payable and other obligations....................................     4,509          5,282
Commitments and Contingencies
Shareholders' equity:
   Preferred Stock,  $1.00 par value -- 3,165,644 shares  authorized
     in 1999 and 1998,  2,500,000  undesignated;  665,644  shares
     designated  as  Series  A Cumulative  Convertible of which
     165,644 shares were issued and outstanding in 1999 and 1998, respectively...       166            166
   Common Stock, $.01 par value -- 50,000,000 shares authorized in
     1999 and 1998; and 5,368,960 and 5,343,092 shares issued in 1999
     and 1998, respectively......................................................        55             53
   Capital in excess of par......................................................    54,172         53,712
   Accumulated deficit...........................................................   (24,117)       (25,548)
   Treasury Stock, at cost -- 511,100 and 340,500 shares in 1999 and
     1998, respectively..........................................................    (1,733)        (1,000)
                                                                                    -------        -------
       Total shareholders' equity................................................    28,543         27,383
                                                                                    -------        -------
       Total liabilities and shareholders' equity................................   $42,826        $43,693
                                                                                    =======        =======

        See accompanying notes to the consolidated financial statements.
</TABLE>

                                       3
<PAGE>
<TABLE>


                            INTEGRAMED AMERICA, INC.,
                      CONSOLIDATED STATEMENT OF OPERATIONS
              (all amounts in thousands, except per share amounts)

<CAPTION>
                                                                                For the                 For the
                                                                          three-month period       nine-month period
                                                                           ended September 30,     ended September 30,
                                                                          --------------------     -------------------
                                                                           1999          1998       1999         1998
                                                                           ----          ----       ----         ----

                                                                               (unaudited)             (unaudited)

<S>                                                                       <C>           <C>        <C>         <C>
Revenues, net..........................................................   $11,862       $9,756     $33,255     $27,927
Costs of services incurred on behalf of Network Sites:
     Employee compensation and related expenses........................     4,620        3,734      12,883      11,050
     Direct materials..................................................     1,785        1,153       4,091       3,359
     Occupancy costs...................................................       766          725       2,674       2,120
     Depreciation......................................................       402          343       1,011         976
     Other expenses....................................................     1,899        1,564       5,373       3,960
                                                                          -------       ------     -------     -------
       Total costs of services.........................................     9,472        7,519      26,032      21,465
                                                                          -------       ------     -------     -------
Network Sites' contribution............................................     2,390        2,237       7,223       6,462
General and administrative expenses....................................     1,611        1,385       4,504       3,856
Amortization of intangible assets......................................       274          234         779         681
Interest income........................................................       (46)         (24)        (88)        (45)
Interest expense.......................................................       121          126         382         306
                                                                          -------       ------     -------     -------
       Total other expenses............................................     1,960        1,721       5,577       4,798

Restructuring and other charges........................................       --           --          --        2,084
                                                                          -------       ------     -------     -------
Income (loss) from continuing operations before income taxes...........       430          516       1,646        (420)
Provision for income taxes.............................................        45           94         217         245
                                                                          -------       ------     -------     -------
Income (loss) from continuing operations...............................       385          422       1,429        (665)

Loss from actual and phase-out period operating losses of
     AWM Division......................................................       --            --         --          923
(Recapture) loss from disposal of AWM Division.........................       --          (350)        --        3,578
                                                                          -------       ------     -------     -------
Net income (loss)......................................................       385          772       1,429      (5,166)
Less: Dividends paid and/or accrued on Preferred Stock.................        33           33          99          99
                                                                          -------       ------     -------     -------
Net income (loss) applicable to Common Stock...........................   $   352      $   739     $ 1,330     $(5,265)
                                                                          =======      =======     =======     =======
Basic and diluted earnings (loss) per share of Common Stock:
     Continuing operations.............................................   $  0.07       $ 0.07     $  0.27     $ (0.15)
     Discontinued operations...........................................     --            0.07        --         (0.86)
                                                                          -------       ------     -------     -------
     Net earnings (loss)...............................................   $  0.07       $ 0.14     $  0.27     $ (1.01)
                                                                          =======       ======     =======     =======
Weighted average shares -- basic.......................................     4,863        5,343       4,910       5,226
                                                                          =======       ======     =======     =======
Weighted average shares -- diluted.....................................     4,981        5,405       5,002       5,226
                                                                          =======       ======     =======     =======


         See accompanying notes to the consolidated financial statements

</TABLE>
                                       4
<PAGE>

<TABLE>

                            INTEGRAMED AMERICA, INC.
                       CONSOLIDATED STATEMENT OF CASH FLOW
                           (all amounts in thousands)
  <CAPTION>
                                                                                               For the
                                                                                          nine-month period
                                                                                          ended September 30,
                                                                                          ------------------
                                                                                           1999        1998
                                                                                           ----        ----
                                                                                             (unaudited)
Cash flows from operating activities:
<S>                                                                                      <C>        <C>
     Net income (loss)................................................................   $1,429     $(5,166)
     Adjustments to reconcile net income (loss) to net cash provided by (used in)
       Operating activities:
         Depreciation and amortization................................................    2,035       1,938
         Write-off of fixed and other assets..........................................       --       5,541
       Changes in assets and liabilities net of effects from acquired businesses --
        Decrease (increase) in assets:
         Patient accounts receivable..................................................      277      (2,733)
         Management fees receivable...................................................      352      (1,075)
         Other current assets.........................................................      567         199
         Other assets.................................................................       81        (111)
       Increase (decrease) in liabilities:
         Accounts payable.............................................................      (96)     (1,222)
         Accrued liabilities..........................................................     (131)       (343)
         Due to Medical Practices.....................................................     (492)        352
         Patient deposits.............................................................      350         878
                                                                                         ------      ------
Net cash provided by (used in) operating activities...................................    4,372      (1,742)
                                                                                         ------     -------
Cash flows (used in) provided by investing activities:
       Purchase of net liabilities of acquired businesses.............................       --         487
       Payment for exclusive management rights and acquired physician practices.......     (213)     (3,165)
       Purchase of fixed assets and leasehold improvements............................   (2,005)     (1,216)
       Proceeds from sale of fixed assets.............................................       --         135
                                                                                         ------      ------
Net cash used in investing activities.................................................   (2,218)     (3,759)
                                                                                         ------      ------
Cash flows provided by (used in) financing activities:
       Proceeds from issuance of Common Stock.........................................       --       5,500
       Used for stock issue costs.....................................................       --         (74)
       Proceeds from bank under Credit Facility.......................................       --       6,000
       Proceeds from IVP Pharmaceutical Care, Inc.....................................      150         --
       Principal repayments on debt...................................................   (1,780)     (2,833)
       Principal repayments under capital lease obligations...........................      (51)        (84)
       Repurchase of Common Stock.....................................................     (733)         --
       Dividends paid on Convertible Preferred Stock..................................      (99)         --
       Proceeds from exercise of Common Stock options.................................       --          99
                                                                                         ------      ------
Net cash (used in) provided by financing activities...................................   (2,513)      8,608
                                                                                         ------      ------
Net (decrease) increase in cash.......................................................     (359)      3,107
Cash at beginning of period...........................................................    4,241       1,930
                                                                                         ------      ------
Cash at end of period.................................................................   $3,882      $5,037
                                                                                         ======      ======
         See accompanying notes to the consolidated financial statements
</TABLE>
                                       5
<PAGE>


                            INTEGRAMED AMERICA, INC.
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                                   (unaudited)

NOTE 1 -- INTERIM RESULTS:

     The  accompanying  unaudited  consolidated  financial  statements have been
prepared in accordance with the instructions to Form 10-Q and,  accordingly,  do
not include all of the information and footnotes  required by generally accepted
accounting  principles  for  complete  financial  statements.  In the opinion of
management,  the accompanying unaudited interim financial statements contain all
adjustments  (consisting  only of normal  recurring  adjustments)  necessary  to
present fairly the financial position at September  30,1999,  and the results of
operations and cash flows for the interim periods  presented.  Operating results
for the interim  periods are not  necessarily  indicative of results that may be
expected  for the year ending  December  31, 1999.  These  financial  statements
should be read in conjunction  with the financial  statements and notes included
in the  Company's  Annual  Report on Form 10-K for the year ended  December  31,
1998.

NOTE 2 -- EARNINGS PER SHARE:

     The  calculation  of the number of shares for basic and diluted EPS for the
three and  nine-month  periods  ended  September 30, 1999 and 1998 is as follows
(000's omitted):
<TABLE>
<CAPTION>

                                                           For the                For the
                                                         three-month             nine-month
                                                        period ended            period ended
                                                        September 30,           September 30,
                                                        -------------           -------------
                                                        1999     1998           1999     1998
                                                        ----     ----           ----     ----
                                                         (unaudited)             (unaudited)

<S>                                                    <C>       <C>           <C>       <C>
Weighted average shares outstanding................... 4,863     5,343         4,910     5,226
Effect of dilutive options and warrants...............   118        62            92        --
                                                       -----     -----         -----     -----
Weighted average shares and dilutive potential
    common shares..................................... 4,981     5,405         5,002     5,226
                                                       =====     =====         =====     =====
</TABLE>

     Income (loss) from  continuing  operations  was the same for both basic and
diluted calculations for all periods presented.

     The  company  determines  earnings  (loss)  per  share in  accordance  with
Financial  Accounting Standards No. 128, "Earnings Per Share," which the Company
adopted in December  1997. All  historical  earnings  (loss) per share have been
presented in accordance with FAS 128.

     For the three and nine-month  periods  ending  September 30, 1999 and 1998,
the following  approximate amounts of common stock from their assumed conversion
were  excluded  in  computing  the  diluted  per  share  amounts  as  they  were
antidilutive.
<TABLE>
<CAPTION>

                    For the three-month period ended September 30,      For the nine-month period ended September 30,
                    ----------------------------------------------      ---------------------------------------------
                     Exercise                Exercise                    Exercise                Exercise
                    Price Range   1999      Price Range    1998         Price Range    1999     Price Range    1998
                    -----------   ----      -----------    ----         -----------    ----     -----------    ----

<S>                 <C>         <C>        <C>          <C>            <C>           <C>       <C>           <C>
Options...........  $4.00-$5.00  403,000    $4.00-$4.12  350,000        $4.00-$5.00   429,000   $4.00-$4.12   350,000
Warrants..........  $4.94-$8.54   75,000    $4.94-$7.20   78,250        $4.94-$8.54    75,000   $4.94-$7.20    78,250
Preferred Stock...      --       133,000        --       523,000            --        133,000       --        523,000

</TABLE>

                                       6

<PAGE>


                            INTEGRAMED AMERICA, INC.
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                                   (unaudited)

NOTE 3 -- MANAGEMENT AGREEMENT:

     In April 1999, the Company formed a new wholly owned subsidiary, IntegraMed
Pharmaceutical  Services,  Inc.  ("IPSI").  IPSI is a licensed pharmacy based in
Carrolton,  Texas.  The primary  business of IPSI is the retail  distribution of
infertility  related  pharmaceuticals  and products to the Reproductive  Science
Centers.  IPSI was formed in conjunction with IVP  Pharmaceutical  Care, Inc., a
licensed pharmacy specializing in dispensing pharmaceutical products, which will
provide certain management services to IPSI.

     Effective May 1, 1999, the Company entered into a new management  agreement
with the Medical Practice at the Reproductive  Science  Associates  Network Site
located in Kansas  City,  Missouri.  Under this new  agreement,  the Company may
enter into management agreements with other medical practices, offering them use
of the Network Site medical  offices and space.  The Company did not pay a right
to manage fee in connection with this agreement,  rather,  the management  right
payable of $213,000 to the Kansas City medical  Practice was netted  against the
management fee receivable (from the Practice).  This  transaction  yielded a net
receivable  due  to  the  Company  of  $835,000.  The  Company  recognizes  this
receivable  as a further  investment  by the Company in the Kansas City  Medical
Practice,  and  has  reclassed  $835,000  from  management  fees  receivable  to
intangible assets in the accompanying Consolidated Balance Sheet.

                                        7
<PAGE>


Item 2.  Management's Discussion and Analysis of Financial Condition and
         Results of Operations

     The following  discussion and analysis  should be read in conjunction  with
the  consolidated  financial  statements  and notes  included in this  quarterly
report  and with the  Company's  Annual  Report on Form 10-K for the year  ended
December 31, 1998.

Results of Operations

     The  following  table shows the  percentage of net revenue  represented  by
various expense and other income items  reflected in the Company's  Consolidated
Statement of Operations.
<TABLE>
<CAPTION>

                                                                      For the             For the
                                                                     three-month         nine-month
                                                                    period ended        period ended
                                                                    September 30,       September 30,
                                                                    -------------       -------------
                                                                    1999     1998       1999     1998
                                                                    ----     ----       ----     ----
                                                                     (unaudited)         (unaudited)

<S>                                                                <C>       <C>       <C>       <C>
Revenues, net...................................................   100.0%    100.0%    100.0%    100.0%
Costs of services incurred on behalf of Network Sites:
   Employee compensation and related expenses...................    39.0%     38.4%     38.8%     39.6%
   Direct materials.............................................    15.0%     11.8%     12.3%     12.0%
   Occupancy costs..............................................     6.5%      7.4%      8.0%      7.6%
   Depreciation.................................................     3.4%      3.5%      3.0%      3.5%
   Other expenses...............................................    16.0%     16.0%     16.2%     14.2%
                                                                    ----      ----      ----      ----
      Total costs of services...................................    79.9%     77.1%     78.3%     76.9%
Network Sites' contribution.....................................    20.1%     22.9%     21.7%     23.1%
General and administrative expenses.............................    13.6%     14.1%     13.7%     13.9%
Amortization of intangible assets...............................     2.3%      2.4%      2.3%      2.4%
Interest income.................................................    (0.4)%    (0.2)%    (0.3)%    (0.2)%
Interest expense................................................     1.0%      1.3%      1.1%      1.1%
                                                                    ----      ----      ----      ----
   Total other expenses.........................................    16.5%     17.6%     16.8%     17.2%
                                                                    ----      ----      ----      ----
Restructuring and other charges.................................     0.0%      0.0%      0.0%      7.5%
Income (loss) from continuing operations before income taxes....     3.6%      5.3%      4.9%     (1.5)%
Provision for income taxes......................................     0.4%      1.0%      0.6%      0.9%
                                                                    ----      ----      ----      ----
Income (loss) from continuing operations........................     3.2%      4.3%      4.3%     (2.4)%
Recapture (loss) from discontinued operations...................     0.0%      3.6%      0.0%    (16.1)%
                                                                    ----      ----      ----      ----
Net income (loss)...............................................     3.2%      7.9%      4.3%    (18.5)%
                                                                    ====      ====      ====      ====
</TABLE>

   Three Months Ended September 30, 1999 Compared to Three Months Ended
   September 30, 1998

     Revenues for the third quarter ended September 30, 1999 were  approximately
22% greater than the same period in 1998. Major Network Site  contributors  were
Fertility Centers of Illinois, Shady Grove Fertility Centers, and RSC of Boston,
each of which comprised more than 10% of total Company revenue.  Management fees
and  reimbursed  cost of services  derived from network  revenues at these sites
increased 21%, 29% and 13%,  respectively.  Increases in patient volume were the
primary cause of the Network Site revenue increases.  IntegraMed  Pharmaceutical
Services,  which was  launched  in the  second  quarter of 1999,  accounted  for
$812,000, or 7%, of third quarter revenue.

                                       8

<PAGE>


     Total  costs of services  were 79.9% of  revenues  in the third  quarter of
1999, compared to 77.1% in the third quarter of 1998. Employee  compensation and
related  expenses  increased  slightly,  primarily  due to  increased  levels of
compensation  and new hires.  Direct  materials  increased  as a  percentage  of
revenues,   primarily   due  to  the  cost  of  products   sold  at   IntegraMed
Pharmaceutical Services.

     Network  Sites'  contribution  reflects  an  increase  of 7% for the  third
quarter of 1999  compared  to the third  quarter of 1998.  Increases  in patient
billings were the primary reason for this increase.  As a percentage of revenue,
Network Sites' contribution  decreased for the third quarter of 1999 as compared
to the third quarter of 1998,  principally  due to the  activation of clauses in
certain  management  contracts  which  decrease  management  fees payable to the
Company as Network Site  contribution  increases.  These clauses are designed to
reward the participating  physicians for increased practice growth. In addition,
margins  at  the   Company's   pharmaceutical   venture  are,  as   anticipated,
significantly lower than those of our core business.

     General  and  administrative  expenses  for the third  quarter of 1999 were
approximately  16% higher  than the third  quarter  of 1998.  The  increase  was
largely due to staffing,  consulting,  and other cost  increases  related to the
development,   implementation  and  maintenance  of  the  Company's  proprietary
ARTWorks suite of fertility care information systems.

     Net interest  expense  decreased in the third quarter  ended  September 30,
1999 due to reductions in short and long-term debt.

     The provision  for income taxes is primarily  related to state taxes as the
Company has utilized available net operating loss carryforwards to eliminate any
Federal tax provision. The provision for income taxes decreased 52% in the third
quarter  of 1999  compared  to the  third  quarter  of 1998 due to a  change  in
effective tax rates as a result of tax planning initiatives.

     In late September 1999, the Company was informed by a hospital,  with which
it has a contract  that  generates a  significant  amount of revenue and Network
Site contribution, that three of the associated practice physicians had resigned
and  established  their own practice.  The hospital is  aggressively  recruiting
replacement  physicians.  While the ultimate  impact of these  events  cannot be
determined,  it is likely that there will be a negative  effect on revenues  and
net earnings of the fourth quarter of 1999 and the first quarter of 2000.

   Nine Months Ended September 30, 1999 Compared to Nine Months Ended
   September 30, 1998

     Revenues  increased  19% for the nine  months  ended  September  30,  1999,
compared to the nine  months  ended  September  30,  1998.  Major  Network  Site
contributors were Fertility Centers of Illinois,  Shady Grove Fertility Centers,
and RSC of  Boston,  each of which  comprised  more  than  10% of total  Company
revenue.  Management fees and reimbursed  costs derived from network revenues at
these sites  increased  19%,  67% and 19%,  respectively.  Increases  in patient
volume  were the primary  cause of the Network  Site  revenue  increases  at the
Fertility Center of Illinois and the RSC of Boston.  Shady Grove results include
only six months of activity for the nine months ended  September 30, 1998 as its
management  contract  with the  Company  was  signed in March  1998.  IntegraMed
Pharmaceutical  Services,  which was  launched  in the  second  quarter of 1999,
accounted  for $925,000,  or 3%, of revenue for the nine months ended  September
30, 1999. Revenue increases were partially offset by the loss of $2.2 million in
revenues related to terminated management agreements.

     For the nine months ended  September  30, 1999  compared to the nine months
ended  September  30, 1998,  total costs of services as a percentage of revenues
increased  to 78.3% from  76.9%.  Employee  compensation  and  related  expenses
declined  as a  percentage  of  revenue  but  increased  in  total by 17% due to
increased  levels of compensation and new hires at the clinical level which were
related to volume.  Other  expenses as a percentage  of revenue  increased  from
14.2% to 16.2% and in total by 36%.  This was  principally  due to  increases in

                                       9

<PAGE>

consulting and information system expenses for the first three quarters of 1999,
as well as increases in bad debt  provisions and management  fees related to the
pharmaceutical  venture.  Direct  materials,  occupancy  costs and  depreciation
remained  relatively  constant as a  percentage  of revenues.  Direct  materials
increased 22% in total  primarily due to the cost of products sold at IntegraMed
Pharmaceutical  Services.  Occupancy  costs  increased 26% in total due to Shady
Grove's  relocation to a newly  constructed  facility.  The above cost increases
were partially offset by the elimination of approximately  $3.0 million of costs
related to the terminated management agreements.

     General and administrative expenses for the nine months ended September 30,
1999   declined   slightly  as  a  percentage  of  revenue  but  in  total  were
approximately  17% higher than for the nine months ended September 30, 1998. The
increase  was  largely due to  staffing,  consulting,  and other cost  increases
related to the  development,  implementation  and  maintenance  of the Company's
proprietary ARTWorks suite of fertility care information systems.

     The provision  for income taxes is primarily  related to state taxes as the
Company has utilized available net operating loss carryforwards to eliminate any
Federal tax provision. The provision for income taxes decreased 11% for the nine
months ended  September 30, 1999 compared to the nine months ended September 30,
1998  due to a change  in  effective  tax  rates  as a  result  of tax  planning
initiatives.

Liquidity and Capital Resources

     Historically,  the Company has financed its  operations  primarily  through
sales of equity  securities.  More recently,  the Company used bank resources to
finance  working  capital and  acquisitions.  The Company  anticipates  that its
acquisition strategy will continue to require substantial capital investment. In
order to effect future  acquisitions,  the Company may pursue a course of equity
or debt financing, or may choose to utilize its existing $9 million bank line of
credit. Capital is needed not only for additional acquisitions, but also for the
effective integration, operation and expansion of the Company's existing Network
Sites.

     As of September 30, 1999, the Company had working capital of  approximately
$6.7 million, compared to $7.7 million at December 31, 1998. The net decrease in
working  capital  was  primarily  due to fixed asset and  leasehold  improvement
purchases of  $2,005,000,  the  repurchase  of 170,600  shares of the  Company's
Common  Stock for an  aggregate  purchase  price of  $733,000  and the  $773,000
reduction in long-term  debt.  These outflows were  partially  offset by inflows
from patient and management fee receivables.

     In November  1999,  the Board of  Directors of the Company  authorized  the
repurchase of up to an additional $2,000,000 of the Company's Common Stock, from
time to time,  at fair market  value,  on the open  market or through  privately
negotiated transactions.

Year 2000 Issue

     The Company's  management has recognized the importance that its operations
and  relationships  with its vendors and other  third  parties not be  adversely
impacted by software  processing errors arising from calculations using the year
2000 and beyond ("Y2K").  As such, the Company has appointed a Y2K Task Force to
identify  and assess  the risks  associated  with its  information  systems  and
operations,  and its interactions with vendors and third-party  insurance payors
("the Y2K Project").  The Y2K Project is comprised of five phases as follows: 1)
identification  of risks,  2) assessment of risks, 3) development of remediation
and  contingency  plans,  4)  implementation,  and 5)  testing.  The Company has
identified and assessed the Y2K risks.  The Company is currently  working on the
last three phases of the Y2K Project.

     The Company  believes that the Y2K risks  associated  with its  information
systems and certain medical equipment may be potentially significant.  In nearly
all cases,  the Company is relying on  assurances  from third party vendors that
certain  information  systems and medical  equipment will be Y2K  compliant.  In

                                       10

<PAGE>

addition,  in the  normal  course of  business,  the  Company  has made  capital
investments  in certain  vendor  supplied  software  applications  and  hardware
systems to address the financial and  operational  needs of its business.  These
systems,  which will improve the  efficiencies  and productivity of the replaced
systems,  have been represented to be Y2K compliant by the vendors and have been
installed  as of November  1999.  The Company has tested,  such vendor  supplied
systems  and  equipment,  but cannot be sure that its tests will be  adequate or
that,  if  problems  are  identified,  they will be  addressed  in a timely  and
satisfactory manner.

     The Company is also highly  dependent  upon  receiving  payments from third
party payors for  insurance  reimbursement  for claims  submitted by the managed
Medical  Practices,  and as such,  the ability of such payors to process  claims
submitted by Medical Practices accurately and timely,  constitutes a significant
risk to the Company's cash flow. The Corporate  Office has been in communication
with these payors throughout the country to ensure that these payors will be Y2K
compliant   and  will  be  able  to  process  the  Medical   Practices'   claims
uninterrupted.  The  network  sites  will  continue  with  "follow-ups"  to this
corporate  initiated process where compliance is in question.  In addition,  the
Company deals with numerous financial institutions,  all of which have indicated
that the Y2K  compliance  issue is being  addressed  proactively  and should not
present a problem on or after January 1, 2000.

     As the Company and its managed Medical  Practices are primarily  reliant on
third  party  vendors  and  payors to be Y2K  compliant,  the  Company  does not
anticipate  that it will  incur a  material  incremental  cost  associated  with
addressing  Y2K  problems.  To  date,  all of  the  Company's  capital  projects
regarding information systems were part of its long-term capital strategic plan.
The timing of  implementation of these capital projects was not accelerated as a
result of the Y2K issue, with the exception of the timing of the installation of
a new financial  system at the FCI Network Site which was  accelerated  from the
year 2000 to 1999. The Company estimates that it will incur an aggregate cost of
$315,000  related to the Y2K  Project as  follows:  (i)  approximately  $140,000
related to computer hardware and software and medical equipment replacements and
upgrades,  of which  approximately  90% will be  capitalizable  due to the added
value  of  such  replacements  and  upgrades;  (ii)  approximately  $130,000  of
non-incremental employee opportunity costs for time spent by information systems
and Y2K Task Force  employees who would have ordinarily been spending their time
elsewhere;  and (iii)  approximately  $45,000 in incremental  staffing costs. By
accelerating the  implementation  of the new financial system at the FCI Network
Site,  approximately $110,000 of capitalizable  equipment and software costs and
approximately  $50,000 of training costs will be incurred in 1999 instead of the
year 2000.

     In the event any third  parties  cannot  timely  provide the  Company  with
information systems,  equipment or services that meet the Y2K requirements,  the
Company's  ability and that of its managed  Medical  Practices to offer services
and to process  sales,  and the Company's  cash flows,  could be  disrupted.  In
addition,  if the Company fails to satisfactorily  resolve Y2K issues related to
its  operations  in  a  timely  manner,   it  could  be  exposed  to  liability,
particularly to the managed Medical  Practices and their patients.  As developed
to  date,  the  Company's  contingency  plan  provides  for the  following:  (i)
stockpiling higher than normal  inventories of critical supplies;  (ii) ensuring
an adequate line of bank credit if third party payor payments are disrupted; and
(iii)  ensuring all critical staff are available or scheduled for work prior to,
during and immediately after December 31, 1999.

     Management  believes  that the Company is taking  reasonable  and  adequate
measures to address  Y2K issues.  However,  there can be no  assurance  that the
Company's  information  systems,  medical  equipment  and other  non-information
technology systems will be Y2K compliant on or before December 31, 1999, or that
vendors and third-party insurance payors are, or will be, Y2K compliant, or that
the costs  required  to address  the Y2K issue will not have a material  adverse
effect on the Company's business, financial condition or results of operations.

                                       11

<PAGE>

     Like  virtually  every  company,  and indeed every  aspect of  contemporary
society,  the  Company  is at  risk  for the  failure  of  major  infrastructure
providers to adequately  address  potential Y2K problems.  The Company is highly
dependent on a variety of public and private infrastructure providers to conduct
its business in numerous jurisdictions  throughout the country.  Failures of the
banking system, basic utility providers,  telecommunication  providers and other
services,  as a result of Y2K problems,  could have a material adverse effect on
the  ability of the  Company  to  conduct  its  business.  While the  Company is
cognizant of these risks, a complete  assessment of all such risks is beyond the
scope of the  Company's  Y2K Project or ability of the  Company to address.  The
Company  has focused its  resources  and  attention  on the most  immediate  and
controllable Y2K risks.

Forward Looking Statements

     This Form 10-Q and discussions and/or announcements made by or on behalf of
the Company, contain certain forward-looking  statements regarding events and/or
anticipated  results  within the meaning of the "safe harbor"  provisions of the
Private  Securities  Litigation  Reform  Act of 1995,  the  attainment  of which
involve  various  risks and  uncertainties.  Forward-looking  statements  may be
identified by the use of  forward-looking  terminology  such as, "may",  "will,"
"expect,"  "believe,"  "estimate,"  "anticipate,"  "continue," or similar terms,
variations of those terms or the negative of those terms.  The Company's  actual
results may differ  materially  from those  described  in these  forward-looking
statements  due to the  following  factors:  the  Company's  ability  to acquire
additional  management  agreements,  including  the  Company's  ability to raise
additional  debt and/or equity  capital to finance  future  growth,  the loss of
significant  management  agreement(s),  the  profitability  or lack  thereof  at
Reproductive  Science Centers managed by the Company,  the Company's  ability to
transition sole  practitioners to group practices,  increases in overhead due to
expansion,  the  exclusion  of  infertility  and  ART  services  from  insurance
coverage,  government laws and  regulations  regarding  health care,  changes in
managed  care  contracting,  the timely  development  of and  acceptance  of new
infertility,  ART  and/or  genetic  technologies  and  techniques  and the risks
relating to Y2K.

Item 3.  Quantitative and Qualitative Disclosures About Market Risk
     Not applicable.

                                       12

<PAGE>



Part II -         OTHER INFORMATION

     Item 1.      Legal Proceedings.
                     None;  no  material  developments  in  previously  reported
                     matters.

     Item 2.      Changes in Securities.
                     None.

     Item 3.      Defaults Upon Senior Securities.
                     None.

     Item 4.      Submission of Matters to Vote of Security Holders.
                     None.

     Item 5.      Other Information.

     Item 6.      Exhibits and Reports on Form 8-K.
                     (a)Exhibits
                            See Index to Exhibits on page 15.

                     (b)Reports on Form 8-K
                            None.



                                      13
<PAGE>







                                                     SIGNATURES


         Pursuant to the  requirements  of the Securities  Exchange Act of 1934,
the  Registrant  has duly  caused  this report to be signed on its behalf by the
undersigned thereunto duly authorized.


                                         INTEGRAMED AMERICA, INC.
                                         (Registrant)




Date:    November 15, 1999               By: /s/John W. Hlywak, Jr.
                                             -----------------------------------
                                             John W. Hlywak, Jr.
                                             Sr. Vice President and
                                             Chief Financial Officer
                                             (Principal Financial and
                                             Accounting Officer)






                                       14

<PAGE>


                                INDEX TO EXHIBITS


Exhibit
Number                               Exhibit
- ------                               -------

10.88(b)  --    Management  Agreement between IntegraMed  America,  Inc. and MPD
                Medical Associates, P.C. dated July 1, 1999.

10.105(c) --    Amendment No. 3 to the Management  Agreement between  IntegraMed
                America,  Inc. and Shady Grove Reproductive Science Center, P.C.
                dated September 1, 1999.

10.113(b) --    Master Lease  Agreement  between Fleet Capital  Corporation  and
                IntegraMed America, Inc.

27        --    Financial Data Schedule





                                       15


                              MANAGEMENT AGREEMENT

                                     Between

                            INTEGRAMED AMERICA, INC.

                                       And

                          MPD MEDICAL ASSOCIATES, P.C.


         THIS  MANAGEMENT  AGREEMENT is dated as of July 1, 1999, by and between
IntegraMed America,  Inc., a Delaware  corporation,  with its principal place of
business  at One  Manhattanville  Road,  Purchase,  New York 10577  ("Management
Company") and MPD Medical  Associates,  P.C., a New York  professional  services
corporation,  with its  principal  place of business  at 200 Old  Country  Road,
Mineola, New York 11501 ("PC").

                                    RECITALS

         PC is a medical  practice  specializing in gynecology and the treatment
of infertility, including the utilization of in vitro fertilization and assisted
reproductive  technology  services (all such medical  services are  collectively
referred to herein as "Infertility Services").

         Management  Company is in the  business  of owning  certain  assets and
providing billing and collection,  and management and administrative services to
medical  practices  specializing in the provision of Infertility  Services,  and
furnishing  such medical  practices  with the necessary  facilities,  equipment,
personnel,  supplies and support staff (collectively,  "Management Services") in
order to assist such medical  practices in the business  aspects of the practice
of their discipline.

         PC and Management Company entered into a management  agreement dated as
of  June  2,  1997,  as  amended  by  agreement  dated  as of  January  1,  1998
(collectively  the "Former  Agreements")  pursuant to which Management  Company,
agreed to provide, among other things, Management Services.

         PC wishes to  continue  engaging  Management  Company  to  provide  the
Management  Services and Management  Company  desires to provide such Management
Services  upon the terms and  conditions  herein  set forth.  PC and  Management
Company  have  determined  the fair  market  value  for the full  complement  of
Management  Services  rendered by  Management  Company and have  determined  and
agreed  to a  management  fee that  will  allow  PC and  Management  Company  to
establish a relationship  permitting  each party to this agreement to devote its
skills and expertise to the appropriate responsibilities and functions.




<PAGE>



         PC and  Management  Company  desire to amend and  restate the terms and
conditions of the Former Agreements.

         NOW THEREFORE,  in consideration of the mutual covenants and agreements
herein  contained and other good and valuable  consideration,  PC and Management
Company agree as follows:


                                    ARTICLE 1

                                   DEFINITIONS

         1.1  DEFINITIONS.  For the purposes of this  Agreement,  the  following
definitions shall apply:

                  1.1.1  "Assets"  shall mean those  fixed  assets  utilized  in
         connection with the operation of PC's medical practice.

                  1.1.2   "Adjustments"  shall  mean  adjustments  for  refunds,
         discounts,  contractual adjustments,  professional courtesies and other
         activities  that  do not  generate  a  collectible  fee  as  reasonably
         determined by Management Company and PC.

                  1.1.3 "Collections"  shall mean the aggregate,  over a six (6)
         month period, of all Physician and Other Professional Collections.

                  1.1.4 "Cost of Services" shall mean all ordinary and necessary
         expenses of PC and all direct ordinary and necessary operating expenses
         of Management  Company,  without  mark-up,  incurred in connection with
         billing, collection, management and administrative services provided by
         Management Company in the management of PC's medical practice,  as more
         specifically defined in Section 2.1.

                  1.1.5  "Facilities" shall mean the medical office and clinical
         space of PC, including the Mineola and Suffolk  Facilities,  as defined
         in Section 3.2 and any satellite locations,  related businesses and all
         medical  group  business  operations of PC, which are utilized by PC in
         its medical practice.

                  1.1.6 "Fiscal  Year" shall mean the 12 month period  beginning
         January 1 and ending December 31 of each year.

                  1.1.7  "Infertility  Services"  shall  mean  medical  care  in
         gynecology  and the treatment of human  infertility,  including but not
         limited to, the provision of in vitro  fertilization and other assisted
         reproductive  services  provided by PC or any  Physician  Employee  and
         Other Professional Employee.



                                        2

<PAGE>



                  1.1.8  "Management Fee" shall mean an annual fee paid by PC to
         Management Company in an amount defined in 6.1.3 of this Agreement.

                  1.1.9 "Professional  Employees" shall mean nurse anesthetists,
         physician  assistants,  nurses,  nurse  practitioners,   psychologists,
         embryologists,  tissue  bank and  laboratory  personnel  and other such
         professional  employees  who may generate  professional  charges.  Such
         Professional   Employees   shall  be  the  employees,   or  independent
         contractors, as the case may be, of the PC.

                  1.1.10 "Physician  Employees" shall mean those individuals who
         are employees or members of PC or are otherwise  under contract with PC
         to provide  professional  services to PC patients and are duly licensed
         as physicians in the State of New York.

                  1.1.11 "Physician and Professional Collections" shall mean all
         fees and revenues  actually  collected each month by or on behalf of PC
         as a result of professional  medical services  personally  furnished to
         patients by the PC and other fees or income  collected by the PC in its
         capacity as a group of professionals,  whether rendered in an inpatient
         or outpatient  setting,  including but not limited to, medical director
         fees or technical fees from medical ancillary services, consulting fees
         and speaking fees.

                  1.1.12 "Other  Employees" shall mean any employee who is not a
         Professional Employee or Physician Employee.  Each Other Employee shall
         be an  Management  Company  employee,  unless such  employee  cannot be
         employed by Management  Company,  in which event such employee shall be
         employed by PC.


                                    ARTICLE 2

                       COST OF SERVICES AND MANAGEMENT FEE

         2.1 "Cost of Services" (as defined in Section 1.1.4)  includes  without
limitation,  the following  costs and expenses,  whether  incurred by Management
Company or PC:

                  2.1.1 Salaries,  fringe benefits and direct costs of all Other
Employees of Management Company working directly in the management, operation or
administration  of the practice and all salaries,  and fringe benefits of all PC
employees (including,  without limitation,  Professional Employees but excluding
Physician  Employees)  providing services at PC, along with payroll taxes or all
other taxes and charges now or hereafter applicable to such personnel;

                  2.1.2  Expenses  incurred  in the  recruitment  of  additional
physicians  for PC,  including,  but not  limited  to  employment  agency  fees,
relocation and interviewing  expenses and any actual  out-of-pocket  expenses of
Management Company personnel in connection with such recruitment effort;


                                        3

<PAGE>



                  2.1.3 Direct marketing expenses of PC, such as direct costs of
printing marketing materials prepared by Management Company;

                  2.1.4 Any sales and use taxes  assessed  against PC related to
the operation of PC's medical practice;

                  2.1.5  Lease  payments,   depreciation   expense   (determined
according to GAAP),  taxes and interest  directly relating to the Facilities and
equipment, and other expenses of the Facilities described in Section 3.2 below;

                  2.1.6 Legal fees paid by  Management  Company or PC to outside
counsel in  connection  with  matters  specific to the  operation  of PC such as
regulatory  approvals  required  as a result of the parties  entering  into this
Agreement;  provided  however,  legal fees  incurred by the parties  hereto as a
result of a dispute  between  the  parties  shall  not be  considered  a Cost of
Services.

                  2.1.7    Fringe benefits provided to Physician Employees;

                  2.1.8 All  insurance  necessary to operate PC including  fire,
theft, general liability and malpractice  insurance for  Physician-Employees  of
the PC;

                  2.1.9 Professional licensure fees and board certification fees
of Physician Employees and Professional Employees rendering Infertility Services
on behalf of PC;

                  2.1.10 Membership in professional  associations and continuing
professional education for Physician Employees and Professional Employees;

                  2.1.11 The direct  costs in  maintaining  a Quality  Assurance
Program described in Section 3.7 herein;

                  2.1.12 Cost of filing fictitious name permits pursuant to this
Agreement;

                  2.1.13 The cost of medical supplies, including but not limited
to drugs,  pharmaceuticals,  products,  substances,  items, laboratory supplies,
office supplies, inventory and utilities; and

                  2.1.14  Such other  costs and  expenses  directly  incurred by
Management Company or PC necessary for the management or operation of PC.

         2.2 Notwithstanding  anything to the contrary contained herein, Cost of
Services shall not include costs of the following:

                  2.2.1 Costs or  expenses  not  included  in the annual  budget
prepared by Management  Company pursuant to Section 3.4 herein,  unless approved
by the Joint Practice Management Board;



                                        4

<PAGE>



                  2.2.2    The Management Fee;

                  2.2.3   Any   proportion   of   Management   Company's   costs
attributable  to its  operation  of its  corporate  offices  or  payment  of its
officers or employees who work out of its corporate offices;

                  2.2.4 Any federal or state income taxes of Management  Company
other than as provided above.

         2.3 The "Management  Fee" shall cover and include all indirect costs of
Management Company including legal, accounting, financial, marketing, management
and administrative  assistance  provided by Management  Company's  corporate and
regional staff.

                                    ARTICLE 3

                DUTIES AND RESPONSIBILITIES OF MANAGEMENT COMPANY

         3.1      MANAGEMENT SERVICES AND ADMINISTRATION.

                  3.1.1 PC hereby appoints  Management  Company as PC's sole and
exclusive manager and administrator of all of its day-to-day  business functions
and grants  Management  Company  all the  necessary  authority  to carry out its
duties and responsibilities pursuant to the terms of this Agreement. PC and only
PC will perform the medical functions of its practice.  Management  Company will
have no authority, directly or indirectly, to perform, and will not perform, any
medical  function.  Management  Company  may,  however,  advise  PC  as  to  the
relationship  between  its  performance  of medical  functions  and the  overall
administrative and business functioning of its practice.

                  3.1.2 Management Company shall, on behalf of PC, bill patients
and collect  professional  fees for Infertility  Services  rendered by PC at the
Facilities,  outside the Facilities for PC's hospitalized  patients, and for all
other Infertility  Services  rendered by any Physician  Employee or Professional
Employee.  PC hereby appoints  Management  Company for the term hereof to be its
true  and  lawful  attorney-in-fact,  for the  following  purposes:  (i) to bill
patients in PC's name and on its  behalf;  (ii) to collect  accounts  receivable
resulting  from such  billing in PC's name and on its  behalf;  (iii) to receive
payments from insurance companies,  prepayments received from health care plans,
and all other third- party payors; (iv) to take possession of and endorse in the
name of PC (and/or in the name of any Physician  Employee or Other  Professional
Employee rendering  Infertility  Services to patients of PC) any notes,  checks,
money orders, and other instruments  received in payment of accounts receivable;
and (v) with the consent of the PC, not to be unreasonably withheld, to initiate
the  institution of legal  proceedings in the name of PC to collect any accounts
and  monies  owed to PC,  to  enforce  the  rights of PC as  creditor  under any
contract or in  connection  with the  rendering of any  service,  and to contest
adjustments and denials by governmental agencies (or its fiscal  intermediaries)
as third-party payors.


                                        5

<PAGE>
                  3.1.3  Management  Company  shall  supervise  and maintain (on
behalf  of  PC)  all  files  and  records  relating  to  the  operations  of the
Facilities, including but not limited to accounting and billing records, patient
medical records,  and collection  records.  Patient medical records shall at all
times be and remain the  property  of PC and shall be located at the  Facilities
and be readily accessible for patient care.  Management  Company's management of
all files and records  shall comply with all  applicable  state and federal laws
and   regulations,   including   without   limitation,   those   pertaining   to
confidentiality of patient records. The medical records of each patient shall be
expressly deemed confidential and shall not be made available to any third party
except in compliance with all applicable laws, rules and regulations. Management
Company  shall have  access to such  records in order to  provide  the  services
hereunder,  to perform billing functions,  and to prepare for the defense of any
lawsuit in which those records may be relevant.  The  obligation to maintain the
confidentiality of such records shall survive termination of this Agreement.  PC
shall have unrestricted access to all of its records at all times.

                  3.1.4  Management  Company  shall supply to PC all  reasonably
necessary  clerical,  accounting,  bookkeeping and computer services,  printing,
postage and duplication services,  medical transcribing  services, and any other
necessary or appropriate  administrative  services reasonably  necessary for the
operation of PC's medical practice at the Facilities.

                  3.1.5 Should PC so direct, Management Company shall design and
implement  a  marketing  and  public  relations  program  on behalf of PC,  with
appropriate  emphasis on public  awareness of the  availability  of  Infertility
Services  from PC,  designed  to  achieve  objectives  defined by PC. The public
relations  program shall be conducted in  compliance  with  applicable  laws and
regulations  governing  advertising by the medical profession.  PC shall approve
all advertising and marketing materials prior to use.

                  3.1.6  Management   Company  shall  assist  PC  in  recruiting
additional  physicians,  including such administrative  functions as advertising
for and identifying  potential candidates,  checking credentials,  and arranging
interviews; provided, however, PC shall interview and make the ultimate decision
as to the  suitability  of any  physician  to  become  associated  with PC.  All
physicians recruited by Management Company and accepted by PC shall be employees
of or independent contractors to PC.

                  3.1.7 Management Company shall negotiate,  but shall not enter
into, and shall  administer all managed care contracts on behalf of PC and shall
consult  with  PC  on  all   administrative   matters  relating   thereto.   The
establishment,  or continuation,  of all managed contracts between the PC or any
of its Physician Employees and any managed care entity or organization, shall be
based on their  financial terms and shall only be with the mutual consent of the
PC and Management Company.

                  3.1.8 Management  Company shall, upon direction of PC, arrange
for legal and accounting  services as may be reasonably required in the ordinary
course of the PC's  operation,  including  the cost of enforcing  any  physician
contract containing  restrictive covenants;  provided,  however, that Management
Company shall have no authority to arrange for any legal or accounting  services
to the extent that the interests of Management  Company and the PC in the matter
in question shall be adverse nor shall Management Company have any obligation to
make any  Advance,  as such  term is used in  Section  6.2,  for such  services.
Nothing contained herein is intended to authorize  Management  Company to settle
any claim made by or against PC.


                                        6

<PAGE>


                  3.1.9  Management  Company shall,  upon the request of the PC,
negotiate  for and cause  premiums  to be paid  with  respect  to the  insurance
provided for in Article 10.

                  3.1.10  Management  Company shall,  take such other reasonable
actions to collect fees and pay expenses of the Facilities in a timely manner as
are deemed  reasonably  necessary to  facilitate  the  operation of PC's medical
practice at the Facilities.

                  3.1.11  Management  Company shall, pay Cost of Services in the
ordinary course of PC's medical  practice,  it being  understood that Management
Company  shall make such payments in the first  instance,  from  Physicians  and
Other  Collections,  after deduction of Management  Fees, and, if necessary,  by
Advances as contemplated by Section 6.3 hereof.

                  3.1.12 If, at the end of any quarter, after the payment of all
Service Fees and draws of the Physician Shareholders,  there shall be profits to
the  PC,  Management  Company  shall,  at the  direction  of the  PC,  make  any
distributions  of such  profits  as  requested  by the PC,  provided  that  such
distributions  leave a reasonable  reserve  towards the next  quarter's  Service
Fees.

         3.2      FACILITIES.

                  3.2.1 Facilities.  Management Company shall provide the office
space and  facilities  necessary for the  operation of PC's medical  practice in
Mineola  ["Mineola  Facilities"] and Suffolk County [Suffolk  Facilities']  [the
Mineola Facilities and Suffolk Facilities are collectively referred to herein as
the "Facilities"], as set forth in Exhibit 3.2 hereto, including but not limited
to,  the  use of the  Facilities,  all  repairs,  maintenance  and  improvements
thereto,   utility  (telephone,   electric,  gas,  water)  services,   customary
janitorial services, refuse disposal and all other services reasonably necessary
in conducting the  Facilities'  physical  operations.  Management  Company shall
provide  for the  cleanliness  of the  Facilities,  and timely  maintenance  and
cleanliness  of  the  equipment,  furniture  and  furnishings  located  therein.
Management Company shall consult with PC regarding the condition,  use and needs
for  the  Facilities,   equipment,   services  and  improvements   thereto.  The
"build-out"  costs for the  Suffolk  Facilities  of  approximately  One  Hundred
Thousand  Dollars  ($100,000.00)  shall be amortized over a ten (10) year period
from  completion  of  the  Suffolk   Facilities  for  occupancy   ("Construction
Investment").

                  3.2.2 Upon the mutual  agreement  of the  parties,  Management
Company and the PC shall  establish  such other sites for the  operation  of the
practice of the PC and, in the absence of a formal written  agreement  governing
the establishment  thereof,  all costs shall be added to the Management  Company
Construction  Investment and  Management  Company and the PC shall assume all of
the obligations, as to such sites as each has with respect to the Facilities.


                                        7

<PAGE>


         3.3      EXECUTIVE DIRECTOR AND OTHER PERSONNEL.

                  3.3.1  EXECUTIVE  DIRECTOR.  Management  Company  will hire an
Executive  Director,  subject to the approval of the Joint  Practice  Management
Board, to manage and administer all of the day-to-day  business functions of the
Facilities.  The  Executive  Director,  subject to the terms of this  Agreement,
shall implement the policies agreed upon by the Joint Practice  Management Board
and will perform the administrative duties assigned by Management Company.

                  3.3.2  PERSONNEL.  Management  Company shall provide all Other
Employees,   who  shall   include   non-professional   support   personnel   and
administrative  personnel,  clerical,  secretarial,   bookkeeping,  billing  and
collection  personnel  reasonably  necessary  for  the  operation  of PC at  the
Facilities. Such personnel shall be under the direction, supervision and control
of  Management  Company.  If PC is  dissatisfied  with the services of any Other
Employee, PC shall consult with Management Company, and Management Company shall
in good  faith  determine  whether  the  employment  of that  employee  warrants
termination.   Management  Company's  obligations  to  utilize   nonprofessional
personnel shall be governed by the overriding principle and goal of facilitating
the  PC's  provision  of high  quality  medical  care and  laboratory  services.
Management  Company  shall make every  effort,  consistent  with sound  business
practices, to honor the specific requests of PC with regard to the assignment of
Management Company's employees, including the Executive Director.

         3.4 FINANCIAL PLANNING AND GOALS. Management Company shall prepare, for
the  approval  of PC,  annual  capital  and  operating  budgets  reflecting  the
anticipated  revenues  and  expenses,  sources and uses of capital for growth of
PC's practice and for the provision of Infertility  Services at the  Facilities.
Management  Company  shall  present the budgets to PC for its  approval at least
thirty (30) days prior to the  commencement of the Fiscal Year. PC shall specify
the targeted  profit margin for PC's practice at the  Facilities  which shall be
reflected in the overall budget,  and Management Company shall manage the PC and
use all  reasonable  efforts to attempt to reach such target.  If the parties do
not agree on the budget for any Fiscal Year, the budget for the preceding Fiscal
Year shall  serve as the budget  until such time as the Budget is the subject of
agreement.  Management  Company's  ability to  disapprove  an item in the Budget
shall be limited to its refusal to advance  monies to the PC pursuant to Section
6.3 of this  Agreement , and  payments to  Management  Company of Service  Fees,
pursuant to Section 6.1 of this Agreement, shall have priority to the payment of
any items to which Management Company makes objection.

         3.5 FINANCIAL  STATEMENTS.  Management  Company  shall  prepare  annual
financial  statements for operations of PC at the Facilities  within ninety (90)
days of the close of the Fiscal Year.  Management  Company shall prepare monthly
financial  statements  containing a balance sheet and  statement of  operations,
which shall be delivered  to PC within  thirty (30) days after the close of each
calendar month.


                                        8

<PAGE>


         3.6 INVENTORY AND SUPPLIES. Management Company shall order and purchase
inventory and supplies,  and such other  materials  which are requested by PC to
enable PC to deliver Infertility Services in a cost-effective manner.

         3.7 LICENSES AND PERMITS  Management Company shall, on behalf of and in
the name of the PC,  coordinate  and  assist the PC in its  application  for and
efforts  to  obtain  and  maintain  all  federal   state  and  local   licenses,
certifications  and regulatory  permits  required for or in connection  with the
operation of the PC and equipment  located at the  Facilities,  other than those
relating to the practice of medicine or the administration of drugs by Physician
Employees.

         3.8  QUALITY  IMPROVEMENT.   Management  Company  shall  assist  PC  in
fulfilling  its  obligations  to maintain a Quality  Improvement  Program and in
meeting the goals and standards of such program.


                                    ARTICLE 4

                        DUTIES AND RESPONSIBILITIES OF PC


         4.1  PROFESSIONAL  SERVICES.  PC shall provide to its patients  medical
treatment,  including  but not limited  to,  Infertility  Services  which can be
covered by the Management Company insureds insurance program.

         4.2  MEDICAL   PRACTICE.   PC  shall  use  and  occupy  the  Facilities
exclusively for the purpose of providing medical services.  The medical practice
conducted  at  the  Facilities  shall  be  conducted  solely  by  physicians  or
Professional Employees employed by or serving as independent contractors to PC.

         4.3      DIRECTION OF PRACTICE

                  4.3.1 PC, as a continuing  condition of  Management  Company's
          obligations under this Management Agreement,  shall at all time during
          the Term be and remain
         legally  organized  and operated to provide  Infertility  Services in a
         manner consistent with state and federal laws.

                  4.3.2  PC   covenants   that  should  a  physician   become  a
         shareholder  of the PC, that a condition  precedent  to the issuance of
         the shares shall be the ratification of this Management Agreement.


                                        9

<PAGE>



                  4.3.3 PC covenants to use diligent  efforts to cooperate  with
         Management  Company in order to obtain necessary  licenses.  Management
         Company  shall  be  primarily   responsible   for  the   administrative
         responsibility  of pursuing,  in behalf of, and in the name of, the PC,
         any and all  necessary  licenses to operate the  laboratory  and tissue
         bank services existing on the date hereof at the Mineola Facility,  and
         any licenses  required at the Suffolk Facility or any other Facility in
         accordance with all applicable laws and regulations. PC agrees that the
         Medical  Director(s)  or Tissue  Bank  Director(s)  shall be  Physician
         Employees or Professional  Employees of the PC and that should there be
         a vacancy in any such  position,  the PC will cause  another  Physician
         Employee or Professional Employee to fill such vacancy.

                  4.3.4 PC acknowledges that it bears all medical obligations to
         patients treated at the facilities and covenants that it is responsible
         for all tissue, specimens,  embryos or biological material ["Biological
         Materials"] kept at the Facilities on behalf of the patients (or former
         patients) of the PC. In the event of a termination  or  dissolution  of
         the PC, or the termination of this Management Agreement for any reason,
         the PC and its members shall have the obligation to account to patients
         and to arrange for the storage or disposal of such Biological Materials
         ["Relocation  Program"].  Management  Company, in such event, shall, at
         the request of the PC, assist in the  administrative  details of such a
         Relocation  Program  for so  long  as  the PC  shall  request  and  the
         Management Fee shall be paid during that time. These  obligations shall
         survive the termination of this Agreement.

                  4.3.5  PC  covenants   not  to  liquidate  or  dissolve  as  a
         Professional  Corporation  except on six months prior written notice to
         Management Company. In the event that any liquidation or dissolution of
         the PC occurs,  for a reason other than the death or  disability of all
         of  the  shareholders,  Management  Company's  obligations  under  this
         Agreement shall cease.

         4.4  COLLECTION  EFFORTS.  PC covenants  agrees that during the term of
this Agreement it will use its diligent efforts to cause its Physician Employees
and  Professional  Employees  to  execute  such  documents  and take such  steps
reasonably  necessary  to assist  billing and  collecting  for patient  services
rendered by PC and its Physician Employees and Professional Employees.


                                    Article 5

                        Joint Duties and Responsibilities

         5.1  FORMATION  AND  OPERATION  OF  JOINT  PRACTICE  MANAGEMENT  BOARD.
Management  Company and PC will  establish  a joint  practice  management  board
("Joint  Practice  Management  Board") which will be responsible  for developing
management and  administrative  policies for the effectuation of this Agreement.
The Joint  Practice  Management  Board  will  consist of  designated  management
representatives from Management Company, one or more PC owners, as determined by


                                       10

<PAGE>



PC, such other PC  physicians,  as  appropriate  and  determined  by PC, and the
Executive Director.  Management  Company's role on the Joint Practice Management
Board will be advisory,  except in circumstances where matters for consideration
involve Cost of Services  items to be paid by Management  Company or Advances by
Management Company, in which event, Management Company shall be entitled to vote
on such matters. For such matters requiring a formal vote, PC shall have one (1)
vote and Management Company shall have one (1) vote. A tie vote will be the same
as a vote against any matter or issue.  The Management  Company's  negative vote
shall mean only that the  Management  Company  shall not advance  money for such
matters,  by way of either  payment  of Costs of  Services  for such  matters or
through the making of Advances, and such negative vote shall not, in any manner,
prevent PC from adopting or pursuing such matter.

         5.2 DUTIES AND RESPONSIBILITIES OF THE JOINT PRACTICE MANAGEMENT Board.
The Joint  Practice  Management  Board shall have,  among others,  the following
duties and responsibilities:

                  5.2.1 ANNUAL BUDGETS AND PROFITABILITY. All annual capital and
         operation  budgets  prepared by Management  Company shall be subject to
         the review,  amendment,  approval and disapproval of the Joint Practice
         Management  Board.  PC covenants  and agrees to use its best efforts to
         assist the Joint Management  Board in achieving the projected  budgets,
         in place  from time to time.  PC and  Management  Company  agree  that,
         recognizing  changes in circumstances,  annual budgets and forecast are
         subject  to  revisions  and,  accordingly,  they  will  cause the Joint
         Practice  Management  Board to modify  the annual  budgets,  as needed,
         including  without  limitation,  staff  reductions,  to ensure  that PC
         operates  in a  profitable  mode which  means that PDE is positive on a
         monthly  basis.  Further,  PC  agrees  that  in  the  event  PC  incurs
         operational  losses at any  point  during  the term of this  Agreement,
         nothing herein shall obligate  Management Company to incur losses under
         this Agreement in order to sustain PC's operations.

                  5.2.2 CAPITAL IMPROVEMENTS AND EXPANSION.  Except as otherwise
         provided  herein,  any  renovation  and  expansion  plans,  and capital
         equipment  expenditures  with  respect  to PC  shall  be  reviewed  and
         approved by the Joint Practice Management Board and shall be based upon
         the  best  interests  of  PC,  and  shall  take  into  account  capital
         priorities,  economic feasibility,  physician support, productivity and
         then current market and regulatory conditions.

                  5.2.3  ADVERTISING  BUDGET.  All annual  advertising and other
         marketing  budgets  prepared by Management  Company shall be subject to
         the review,  amendment,  approval and disapproval of the Joint Practice
         Management Board.


                  5.2.4    EXECUTIVE DIRECTOR AND KEY PERSONNEL.

                  (a) The  selection  and  retention of the  Executive  Director
         pursuant to Section 3.3.1 by Management Company shall be subject to the


                                       11

<PAGE>



         approval of the Joint Practice  Management Board. If PC is dissatisfied
         with the services provided by the Executive Director,  PC shall consult
         with Management Company who shall, in good faith, determine whether the
         performance  of the Executive  Director  could be brought to acceptable
         levels  through  counsel  and  assistance,  or  whether  the  Executive
         Director should be terminated.

                  (b) Management Company shall follow the recommendations of the
         Joint Practice Management Board with respect to the hiring, terminating
         or  relocating  of  key  personnel  at  PC  Facilities,  provided  such
         recommendations do not cause Management Company to violate any federal,
         state or local laws or regulations.


                                    ARTICLE 6

                             FINANCIAL ARRANGEMENTS

         6.1 SERVICE FEES. The compensation set forth in this Article 6 shall be
paid to Management  Company in consideration of the substantial  commitment made
and services to be rendered by  Management  Company  hereunder  and shall not be
interpreted or applied as permitting  Management Company to share in the fees of
the PC. Prior to entering  into this  Agreement,  the parties have  computed the
Cost of  Services of the P.C.  for the past full fiscal year and have  projected
the Costs of Services for the full calendar year of this agreement. The bases of
the negotiated,  fixed  Management Fee, which the parties agree to represent the
fair market value of services,  supplies and  facilities,  include,  but are not
limited to, a combined  figure of (1) reasonable  market value of the equipment,
contract  analysis  and  support,  support  services,   purchasing,   personnel,
Facilities, management,  administration,  other services and capital provided by
Management  Company;  (2) value to be  received  monthly  by PC as the result of
Management Company's purchase of accounts receivable pursuant to 6.2 hereof; (3)
The value of  Management  Company's  Construction  Investment;  (4) the value of
insurance  coverages  made  available  to PC through  group rates  available  to
Management  Company;  (5) the increased  value to PC as the result of Management
Company's access to better rates for supplies through bulk purchase; and (6) the
ability of Management Company to manage the practice with greater  profitability
to PC. The  negotiated  compensation  is  intended  to account  for the  nature,
quantity  and quality of  services  required,  and  financial  risks  assumed by
Management Company under this Management Agreement.  Management Company shall be
paid the following amounts (collectively "Service Fees"):

                  6.1.1  An  amount  reflecting  all Cost of  Services  (whether
         incurred by  Management  Company or PC) paid or recorded by  Management
         Company from Management  Company's own funds,  pursuant to the terms of
         this Agreement; and

                  6.1.2 Repayment of any Advances or Discretionary Advances; and

                  6.1.3 Management Fee of $45,000 (Forty-Five  Thousand Dollars)
         per month ("Monthly Management Fee").

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<PAGE>




         6.2 COLLECTIONS AND MANAGEMENT COMPANY PURCHASE OF ACCOUNTS RECEIVABLE.
On or before the 20th  business  day of each  month,  Management  Company  shall
reconcile the accounts receivable of the PC arising during the previous calendar
month.  Accounts  receivable  shall be defined as all  receivable  recorded each
month (net of Adjustments) on the books of the PC ["Accounts  Receivable"].  The
adjustments  made shall only  reflect  actual  collection  history of the PC and
Management  Company  shall  pay  dollar-for-dollar  on  such  Adjusted  Accounts
Receivable.  Management Company shall transfer or pay such amount of funds to PC
equal to the Accounts Receivable less Cost of Services and Basic Management Fee,
the latter payment  subject to Sections  3.1.12 and 3.1.13.  Management  Company
shall,  in addition,  transfer such portion of the Service Fees necessary to pay
such portion of the Cost of Services  which are costs and expenses of the PC, as
described in Section 2.1 hereof. PC shall cooperate with Management  Company and
execute  all  necessary  document  necessary  to  effect an  assignment  of such
Accounts Receivable to Management Company or, at Management Company's option, to
its lenders. All collections in respect of such Accounts Receivable shall be the
property  of  Management  Company  and  deposited  in a bank  account  at a bank
designated  by  Management  Company.  To  the  extent  that  the PC  comes  into
possession  of any payments  which are in  satisfaction  or all, or any part, of
such  Accounts  Receivable,  the PC shall  direct such  payments  to  Management
Company for deposit in bank accounts designated by Management Company.

         6.3 ADVANCES.  Management Company agrees to advance funds to PC to meet
Cost of Services, or provide working capital ["Advances"], although the purchase
of Accounts Receivable and the Management Company Construction  Investment shall
not be constitute Advances.  Management Company may, in its sole discretion,  at
the request of the PC,  advance  funds to fund mergers with other  physicians or
physician  groups  into  PC  ["Discretionary  Advance(s)"].   All  Advances  and
Discretionary  Advances  shall be made only with the mutual  agreement of PC and
Management Company.

                  6.3.1 Any Advances or Discretionary  Advances made pursuant to
         this Management Agreement shall be a debt owed to Management Company by
         PC and  shall  have  payment  priority  over any  distribution  to PC's
         Physician-Shareholder(s).   Any  Advance   shall  be  repaid  from  any
         distribution  to  Physician-Shareholder(s)  of PC  either as a lump sum
         payment, within 60 days after the advance, or in installments as agreed
         to by Management Company.

                  6.3.2  Interest  expense  will be  charged  for  Advances  and
         Discretionary  Advances  and will be computed at the Prime Rate used by
         Management  Company's  primary  bank,  from  time to time  (the  "Prime
         Rate").  Advances  shall be evidenced by a security  agreement,  in the
         form of Exhibit 6.3.2,  giving Management Company a collateral interest
         in all accounts receivable and distributions to PC's Shareholder(s).


                                       13

<PAGE>

         6.4 The Monthly  Management  Fee provided for in Section 6.1.3 shall be
adjusted on the dates indicated below, and as adjusted, shall become the Monthly
Management Fee for the applicable period:

                  6.4.1  For the  Fiscal  Year  commencing  January  1, 2000 the
         Monthly Management Fee shall be the greater of (i) $45,000 multipied by
         a fraction,  the numerator of which shall be the Consumer  Price Index[
         (the "CPI" as  hereinafter  defined)  for "All Items" shown on the "New
         York  Metropolitan   Area"  (unadjusted  for  seasonal   variation)  as
         promulgated  by the Bureau of Labor  Statistics  of the  United  States
         Department of Labor  ("Department of Labor") for the month of September
         1999 and the  denominator  of which  shall be the CPI for the  month of
         September  1998. In the event that a substantial  change is made by the
         Department  of Labor in the  method  by  which  the CPI is  established
         during the term of this  Agreement,  then the CPI shall be  adjusted to
         the figure that would have resulted had no change occured in the manner
         of  computing  the  CPI.  If the CPI as  defined  herein  is no  longer
         published  by the  Department  of Labor,  a  reliable  governmental  or
         nonpartisan  publication evaluating the information theretofore used in
         detemining the CPI shall be used in lieu thereof],  or (ii)  $47,500.00
         per month.

                  6.4.2 For the Fiscal  Year  commencing  January  1, 2001,  the
         Monthly Management Fee shall be the greater of (i) $45,000 multipied by
         a fraction,  the numerator of which shall be the Consumer  Price Index[
         (the "CPI" as  hereinafter  defined)  for "All Items" shown on the "New
         York  Metropolitan   Area"  (unadjusted  for  seasonal   variation)  as
         promulgated  by the Bureau of Labor  Statistics  of the  United  States
         Department of Labor  ("Department of Labor") for the month of September
         2000 and the  denominator  of which  shall be the CPI for the  month of
         September 1998 or (ii) $50,000 per month.

                  6.4.3 For the Fiscal  Year  commencing  January  1, 2002,  the
         Monthly Management Fee shall be the greater of (i) $45,000 multipied by
         a fraction,  the numerator of which shall be the Consumer  Price Index[
         (the "CPI" as  hereinafter  defined)  for "All Items" shown on the "New
         York  Metropolitan   Area"  (unadjusted  for  seasonal   variation)  as
         promulgated  by the Bureau of Labor  Statistics  of the  United  States
         Department of Labor  ("Department of Labor") for the month of September
         2001 and the  denominator  of which  shall be the CPI for the  month of
         September 1998 or (ii) $52,000 per month.

                  6.4.4 For the Fiscal  Year  commencing  January  1, 2003,  the
         Monthly Management Fee shall be the greater of (i) $45,000 multipied by
         a fraction,  the numerator of which shall be the Consumer  Price Index[
         (the "CPI" as  hereinafter  defined)  for "All Items" shown on the "New
         York  Metropolitan   Area"  (unadjusted  for  seasonal   variation)  as
         promulgated  by the Bureau of Labor  Statistics  of the  United  States


                                       14

<PAGE>



         Department of Labor  ("Department of Labor") for the month of September
         2002 and the  denominator  of which  shall be the CPI for the  month of
         September 1998 or (ii) $55,000 per month.

                  6.4.5 For the Fiscal  Year  commencing  January  1, 2004,  the
         Monthly Management Fee shall be the greater of (i) $45,000 multipied by
         a fraction,  the numerator of which shall be the Consumer  Price Index[
         (the "CPI" as  hereinafter  defined)  for "All Items" shown on the "New
         York  Metropolitan   Area"  (unadjusted  for  seasonal   variation)  as
         promulgated  by the Bureau of Labor  Statistics  of the  United  States
         Department of Labor  ("Department of Labor") for the month of September
         2003 and the  denominator  of which  shall be the CPI for the  month of
         September 1998 or (ii) $57,500 per month.

                  6.4.6 For the Fiscal  Year  commencing  January  1, 2005,  the
         Monthly  Management Fee shall be an amount that Management  Company and
         PC shall have  negotiated  in advance of January 1, 2005.  In the event
         Management  Company  and PC shall  not have  prior to  January  1, 2005
         agreed upon a Monthly  Management  Fee for the Fiscal  Year  commencing
         January 1, 2005,  then the 2004 Monthly  Management Fee in effect prior
         to  January  1,  2005  shall  continue  in  effect  until  such time as
         Management Company and PC shall agree upon a Monthly Management Fee for
         the  Fiscal  Year  commencing  January 1, 2005.  For each  Fiscal  Year
         subsequent to January 1, 2005, Management Company and PC shall likewise
         negotiate a Monthly Management Fee. In the event Management Company and
         PC are unable to negotiate  successfully  a Monthly  Management Fee for
         such subsequent Fiscal Years, then the Monthly Management Fee in effect
         prior to the  commencement  of any such Fiscal Year shall pertain until
         such  time  as  Management   Company  and  PC  are  able  to  negotiate
         successfully a Monthly  Management Fee for the applicable  Fiscal Year,
         which agreed upon Monthly  Management  Fee shall be  retroactive to the
         commencement of such Fiscal Year.


                                    ARTICLE 7

                  EXCLUSIVE MANAGEMENT RIGHT, TERM AND RENEWAL

         7.1 PC grants to Management  Company the  exclusive  right to manage PC
during  the  term of this  Agreement  (the  "Exclusive  Management  Right").  In
consideration of the Exclusive  Management Right,  Management  Company agrees as
follows:

                  7.1.1 Management  Company shall pay Dr. San Roman  $100,000.00
         (One  Hundred  Thousand  Dollars)  in cash within 30 days after Dr. San
         Roman and PC cause another physician to become a senior equity owner of
         PC on or before  December  31, 1999 and  completes  three (3) months of
         practice  at  the PC  ("Second  Shareholder").  For  purposes  of  this
         Agreement  "senior equity owner" shall mean a physician owning not less
         than a twenty-six per cent (26%) interest in PC.

                                       15

<PAGE>



                  7.1.2 Management  Company shall pay Dr. San Roman  $100,000.00
         (One Hundred Thousand Dollars) in cash within 30 days after PC, Dr. San
         Roman and the Second Shareholder cause a third Physician-Shareholder to
         become a equity  owner of PC with  not less  than a ten  percent  (10%)
         equity  interest  which 10% interest  shall become not less than twenty
         (20%)    within   36   months    thereafter.    In   the   event   such
         Physician-Shareholder  does not become at least a twenty  percent (20%)
         equity  owner  within  the 36  months,  Dr.  San Roman  shall  remit to
         Management Company, the amount paid pursuant to this Section, within 30
         days after demand by Management Company.

         7.2 The term of this  Agreement  shall  begin on July 1, 1999 and shall
expire ten (10) years  after such date  unless  earlier  terminated  pursuant to
Article 8 below.  This  Agreement may be renewed by either party,  if within the
period of 180 days prior to the date of  expiration,  one party gives  notice to
the other of its intention to continue this  Agreement  under the same terms and
conditions as set forth herein or under such  different  terms and conditions as
particularly  set forth in the  written  notice and further  providing  that the
other party has 30 days from the date of notice to accept,  reject or modify the
offer.  If within 30 days the other party does not respond or by written  notice
accepts,  this  Agreement  shall  continue for an  additional 10 years under the
terms and  conditions  as provided in the notice.  In the event the offer is not
accepted,  the parties  agree to  negotiate,  in good  faith,  a renewal of this
Agreement.


                                    ARTICLE 8

                          TERMINATION OF THE AGREEMENT


         8.1  TERMINATION.  This  Agreement may be terminated by either party in
the event of the following:

                  8.1.1 INSOLVENCY. If a receiver,  liquidator or trustee of any
         party shall be appointed by court  order,  or a petition to  reorganize
         shall be filed against any party under any  bankruptcy,  reorganization
         or  insolvency  law, and shall not be dismissed  within 90 days, or any
         party shall file a voluntary  petition in bankruptcy or make assignment
         for the  benefit of  creditors,  then  either of the other  parties may
         terminate this Agreement upon 10 days prior written notice to the other
         parties.

                  8.1.2 MATERIAL BREACH. If either party shall materially breach
         its  obligations  hereunder,  then  either  of the  other  parties  may
         terminate  this  Agreement by providing 30 days prior written notice to
         the breaching party  detailing the nature of the breach,  provided that
         the breaching  party shall not have cured the breach within such 30 day
         period,  or, with respect to breaches that are not curable  within such
         30 day period, shall not have commenced to cure such breach within such
         30 day

                                       16

<PAGE>



         period and thereafter shall not have cured the breach with the exercise
         of due diligence.

                  8.1.3  ILLEGALITY.  Either party may terminate  this Agreement
         immediately upon receipt of notification by any local, state or federal
         agency or court of competent jurisdiction that the conduct contemplated
         by this Agreement is forbidden by law; except that this Agreement shall
         not terminate during such period of time as to any party which contests
         such  notification  in good faith and the conduct  contemplated by this
         Agreement is allowed to continue during such contest.  If any governing
         regulatory  agency asserts that (i) the services provided by Management
         Company  under  this  Agreement  are  unlawful,  (ii) the  practice  of
         medicine by PC as contemplated  by this Agreement is unlawful,  or (ii)
         the services  provided by Management  Company requires a certificate of
         need;  and any such  assertion is not contested  (or if contested,  the
         agency's  assertion  is found  to be  correct  by a court of  competent
         jurisdiction  and no appeal is taken,  or if any  appeals are taken and
         the same are  unsuccessful),  this Agreement shall thereupon  terminate
         with the same force as if such termination date was the date originally
         specified  in this  Agreement  as the date of final  expiration  of the
         terms of this Agreement.  Notwithstanding  this paragraph,  the parties
         acknowledge  that this  Agreement  serves the  interests of both PC and
         Management  Company and,  specifically,  affords PC the opportunity for
         growth,  and  self-direction,  and provides access to essential capital
         and cash flow. For these reasons,  PC agrees to make such amendments to
         this  Agreement as are  necessary to conform to the  opinions,  reviews
         and/or orders of regulatory and/or administrative agencies of the State
         of New  York,  such as to  preserve  the  legality  of  this  Agreement
         provided that such are not to the financial detriment of the PC.


                  8.1.4  TERMINATION  UPON TWELVE MONTHS WRITTEN NOTICE.  Either
         party may  terminate  this  Agreement  upon twelve  (12)  months  prior
         written notice.

         8.2  TERMINATION BY MANAGEMENT  COMPANY FOR  PROFESSIONAL  DISCIPLINARY
ACTIONS.  Management  Company may terminate  this  Agreement  upon 10 days prior
written notice to PC if any PC shareholder's,  having an equity ownership of 25%
or more ("25%  Shareholder"),  authorization to practice  medicine is suspended,
revoked or not  renewed,  or if any other  formal  disciplinary  action is taken
against  any 25%  Shareholder  which  could  reasonably  lead  to a  suspension,
revocation or non-renewal of a 25% Shareholder's license.

         8.3  TERMINATION  BY  MANAGEMENT  COMPANY  FOR  FAILURE  OF PC  TO  ADD
ADDITIONAL  PHYSICIANS.  Management Company may terminate this Agreement upon 30
days  prior  written  notice  to  PC if PC  fails  to  increase  the  number  of
shareholders, pursuant to Section 7.1.2 by July 1, 2002.



                                       17

<PAGE>

                                    ARTICLE 9

                             RIGHTS UPON TERMINATION

         9.1 If  this  Agreement  is  terminated  for  any  reason,  other  than
illegality,  or the insolvency or material  breach by Management  Company,  then
Management Company and the PC agree as follows:

                  9.1.1 PC shall  purchase,  and Management  Company shall sell,
         any  Assets  at the  net  book  value  determined  in  accordance  with
         generally accepted accounting principles consistently applied as to the
         date of termination.  Should this Agreement  terminate prior to October
         1,  2002,  then the PC shall  pay to  Management  Company  not only the
         unamortized portion of Management  Company's  Construction  Investment,
         but  interest  on such  amount,  to be  computed  at the Prime Rate and
         retroactive to the date or dates of such Construction Investment.

                  9.1.2 PC shall  assume all leases for  offices  and  equipment
         used directly for the  management  and operation of the PC's  business,
         both at the Mineola and Suffolk  sites and any other sites  existing as
         of the date of termination, or if assumption is not permitted, make all
         payments called for by such leases, to Management Company.

                  9.1.3  PC  shall  notify,  within  30  days  of  the  date  of
         termination,  all patients with Biological  Materials in storage at the
         Facility,  that  Management  Company will no longer provide  management
         services  and that the care and  custody of such  Biological  Materials
         rests solely with the PC. The form of such  notification  shall be with
         the consent of Management  Company (such consent not to be unreasonably
         withheld).

                  9.1.4 PC shall  repay any  indebtedness,  owned to  Management
         Company as the result of  Advances,  Discretionary  Advances or Service
         Fees. In addition, any unamortized portions of the payments made to Dr.
         San Roman  pursuant to Sections  7.1.1 and 7.1.2 shall be repaid by Dr.
         San Roman within 30 days of the date of termination. For purposes of an
         amortization  of the  payments  pursuant to  Sections  7.1.1 and 7.1.2,
         Management  Company  will  amortize  such  payments  over a  three-year
         period.

                  9.1.5 The sale and purchase,  assumptions  and/or  assignments
         contemplated  by sections  9.1.1 and 9.1.2 shall be  accomplished  at a
         closing to be held within 60 days of the effective  date of termination
         (or sooner shall the parties  mutually  agree) and any and all payments

                                       18

<PAGE>



         to  IntegraMed  shall be  made,  in equal  monthly  installments,  over
         thirty-six  months,  payment to  commence on the first day of the first
         full month following the termination date.

         9.2 If this Agreement  terminates as the result of  illegality,  or the
insolvency or material  breach by  Management  Company,  then PC and  Management
Company agree as follows:

                  9.2.1 PC shall have the  option,  but not the  obligation,  to
         purchase,  and  Management  Company  shall,  upon the  exercise of such
         option sell, any Assets at the net book value  determined in accordance
         with generally accepted accounting  principles  consistently applied as
         to the date of termination.

                  9.2.2 PC shall have the  option,  but not the  obligation,  to
         assume all leases for  offices  and  equipment  used  directly  for the
         management and operation of the PC's business,  both at the Mineola and
         Suffolk  sites  and  any  other  sites  existing  as  of  the  date  of
         termination,  or if  assumption  is not  permitted,  make all  payments
         called for by such leases, to Management  Company.  Management  Company
         agrees to assign its rights to such  facilities  should the PC exercise
         its option, or accept payments in lieu of assumption.

                  9.2.3  Management  Company will notify,  within 30 days of the
         date of termination,  all patients with Biological Materials in storage
         at the  Facility,  that  Management  Company  will  no  longer  provide
         management  services  and that the care and custody of such  Biological
         Materials rests solely with the PC. The form of such notification shall
         be with the  consent of  Management  Company  (such  consent  not to be
         unreasonably withheld).

                  9.2.4 The PC shall repay any indebtedness,  owed to Management
         Company as the result of  Advances,  Discretionary  Advances or Service
         Fees.

                  9.2.5 PC shall exercise its the options  provided in 9.2.1 and
         9.2.2, by written notice to Management  Company within thirty (30) days
         of  the  effective  date  of   termination.   The  sale  and  purchase,
         assumptions and/or assignments contemplated by sections 9.1.1 and 9.1.2
         shall be  accomplished  at a closing  to be held  within 75 days of the
         effective  date of  termination  (or sooner shall the parties  mutually
         agree) and any and all payments to  IntegraMed  shall be made, in equal
         monthly installments,  over twenty-four months,  payment to commence on
         the first day of the first full month following the termination date.

         9.3  In the  event  of  termination  for  any  reason,  the  continuing
obligations  delineated  in Article 11, and Sections  12.14,  and 12.15 (and any
subparts thereof) shall continue pursuant to their terms.



                                       19

<PAGE>



                                   ARTICLE 10

                                    INSURANCE

         10.1  Management  Company  shall use its best efforts to cause PC to be
made an additional  insured under Management  Company's  professional  liability
coverage;  provided,  however,  conditions for being made an additional  insured
shall be (i) PC utilizing  patient informed consent forms supplied by Management
Company,  provided such forms are consistent with law and any guidelines  issued
by the American  Society of  Reproductive  Medicine  and (ii) PC complying  with
requirements of Management Company's insurance company. Management Company shall
also carry a policy of public  liability  and  property  damage  insurance  with
respect to the Facilities under which the insurer agrees to indemnify Management
Company  and PC against all cost,  expense  and/or  liability  arising out of or
based upon any and all  claims,  accidents,  injuries  and  damages  customarily
included  within the  coverage  of such  policies  of  insurance  available  for
Management  Company.  The minimum limits of liability of such insurance shall be
$1 million  combined  single limit covering  bodily injury and property  damage.
Certificates of Insurance evidencing such policies and additional insured status
shall be  presented  to PC  within  thirty  (30) days  after  such  coverage  is
effected.  In the event  Management  Company is unable to cause PC to be made an
additional insured under Management Company's  professional  liability coverage,
PC  shall  carry  professional  liability  insurance  covering  itself  and  its
employees  providing  Infertility  Services under this Agreement.  Such coverage
shall be in the  minimum  amount of $1 million per  incident,  $3 million in the
aggregate.

         10.2 PC and  Management  Company  shall provide  written  notice to the
other  at  least  thirty  (30)  days in  advance  of the  effective  date of any
reduction,  cancellation or termination of the insurance  required to be carried
by each hereunder.

         10.3 As part of PC's  participation,  in any manner,  in an  Management
Company insurance program,  and in an effort to assist Management Company in the
maintenance of its owns insurance, PC agrees to the following obligations, which
represent  an effort to reduce  risk and  maintain  a cost  effective  insurance
program:

                  10.3.1  PC  shall   provide   medical   treatment,   including
         Infertility Services in compliance at all times with ethical standards,
         laws and regulations  applying to the practice of medicine in the State
         of New York.  PC shall  ensure  that  each  Physician  Employee,  Other
         Professional  Employee and any other professional  provider  associated
         with PC is duly licensed to provide the services being rendered  within
         the scope of such provider's  practice.  In addition,  PC shall require
         each  Physician  Employee  during  the  term of this  Agreement  (1) to
         maintain  a DEA  number;  (2) to  maintain  appropriate  medical  staff
         privileges as determined by PC and (3) to obtain board certification in
         Reproductive  Endocrinology  within  five  (5)  years  of  a  Physician
         Employee's completion of an accredited training program or, to have the
         equivalent  training  and  experience  at a foreign  university  and/or


                                       20

<PAGE>



         medical center.  In the event that any disciplinary  actions or medical
         malpractice  actions are initiated  against any such physician or other
         professional  provider,  PC  shall  immediately  inform  the  Executive
         Director and provide the  underlying  facts and  circumstances  of such
         action.

                  10.3.2 PC shall retain that number of  Physician  Employees as
         are  reasonably   necessary  and   appropriate  for  the  provision  of
         Infertility  Services.  However,  PC shall hire  Physicians  ["Incoming
         Physician"] only (1) with the consent, not to be unreasonably withheld,
         of  Management  Company,  and  upon  notice  and  investigation  of the
         insurer.

                  10.3.3 Each Physician Employee shall hold and maintain a valid
         and unrestricted license to practice medicine in New York, and shall be
         competent in the practice of obstetrics and  gynecology,  including the
         subspecialty of infertility and assisted reproductive medicine.

                  10.3.4  PC  shall   insure  that   Physician   Employees   and
         Professional  Employees  provide  patient care and  clinical  backup as
         required to insure the proper  provision of services to patients of the
         PC at the Mineola and Suffolk  Facilities,  and/or such other locations
         as shall be mutually agreed to by PC and Management  Company.  PC shall
         insure that its Physician  Employees and Professional  Employees devote
         substantially  all of their  professional  time,  effort and ability to
         PC's practice,  including the provision of Infertility Services and the
         development of such practice.

                  10.3.5 In the Event of any Relocation Program, as described in
         section  4.3.4,  such shall be conducted by the PC in  accordance  with
         patient consent and the ethical  guidelines of the American  Society of
         Reproductive Medicine.

                  10.3.6 PC shall  undertake  and use its best efforts to locate
         physicians who, in PC's judgment, possess the credentials and expertise
         necessary to enable such physician candidates to become affiliated with
         PC for the purpose of providing Infertility Services.

                  10.3.7 PC covenants  for itself and will use diligent  efforts
         to cause its Physician  Employees and Professional  Employees to comply
         with  reasonable  personnel  policies and guidelines  developed for the
         practice  of  the  PC  by  Management  Company,   which  shall  include
         administrative  protocols and policies designed to insure that the work
         sites complies with all applicable  laws and  regulations,  federal and
         state.



                                       21

<PAGE>


                  10.3.8  PC  shall   require  its   Physician   Employees   and
         Professional  Employees  to  participate  in  such  continuing  medical
         education as PC deems to be reasonably necessary for such physicians or
         Professional   Employees  to  remain   current  in  the   provision  of
         Infertility Services.

                  10.3.9 PC shall  cooperate in the  obtaining  and retaining of
         professional   liability  insurance  by  assuring  that  its  Physician
         Employees   and  Other   Professional   Employees   are  insurable  and
         participating  in an on-going risk management  program.  PC shall cause
         its Physician Employees and Professional  Employees to cooperate in any
         risk management program created and/or operated by Management Company.


                                   ARTICLE 11

                      NON-SOLICITATION AND NON-COMPETITION

         11.1 The PC recognizes and  acknowledges  that Management  Company will
incur substantial costs in providing the equipment, support services, personnel,
management,  administration  and other  services  that are the  subject  of this
Agreement.  The  parties  also  recognize  that the  services  to be provided by
Management  Company will be feasible only if the PC operates an active  practice
to  which  the  Employee-Physicians  devote  their  full  professional  time and
attention.  PC agrees that the  non-competition and  non-solicitation  covenants
described hereunder are necessary for the protection of Management Company,  and
that  Management  Company would not enter this  Agreement  without the following
covenants:

                  11.1.1  During  the  term  of this  Agreement,  PC  shall  not
         establish, operate or provide Infertility Services at a medical office,
         clinic or other health care facility other than as provided for in this
         Agreement.

                  11.1.2 During the Term of this Agreement,  and for a period of
         two years  from the date it is  terminated,  PC shall not  directly  or
         indirectly own, manage, operate,  control, contract with, be associated
         with or  lend  its or its  shareholders'  names  to,  or  maintain  any
         interest whatsoever in any enterprise (i) which provides,  distributes,
         promotes  or  advertises  any  type  of  management  or  administrative
         services in competition with Management  Company;  or (ii) which offers
         any type of service or product to third parties  substantially  similar
         to those offered by Management Company.

                  11.1.3  During the term of this  Agreement,  and for two years
         from the date of  termination,  PC shall  not  hire,  attempt  to hire,
         contract  or  solicit  for  hiring  or  consultancy,  any  employee  of
         Management Company, or form a corporation, partnership or joint venture
         or other entity with any such  employee,  who is currently  employed by
         Management  Company or had been employed by Management  Company  within
         one (1) year prior to the termination of this Agreement.

                                       22

<PAGE>



         Notwithstanding  anything to the contrary  contained herein, the PC may
         (1) continue the employment of any Professional  Employees  employed by
         the PC as of the date of notice of  termination of this  Agreement,  or
         effective date of termination of this Agreement (whichever is earlier);
         and (ii) hire,  attempt  to hire,  contract  or  solicit  for hiring or
         consultancy Sue McGreevy.


                                   ARTICLE 12

                                  MISCELLANEOUS

         12.1 INDEPENDENT CONTRACTOR.  Management Company and PC are independent
contracting parties. In this regard, the parties agree that:

                  12.1.1 The relationship  between  Management Company and PC is
         that of an independent  supplier of non-medical  services and a medical
         practice,  respectively, and, unless otherwise provided herein, nothing
         in this  Agreement  shall be  construed  to  create a  principal-agent,
         employer-employee,  or master-servant  relationship  between Management
         Company and PC;

                  12.1.2  Neither PC nor  Management  Company  (on behalf of PC)
         shall seek or accept  payment  from  Medicare or Medicaid  for services
         provided by PC;

                  12.1.3  Notwithstanding  the  authority  granted to Management
         Company  herein,  Management  Company and PC agree that PC shall retain
         the full  authority  to direct all of the  medical,  professional,  and
         ethical aspects of its medical practices;

                  12.1.4 Any powers of PC not specifically  vested in Management
         Company by the terms of this Agreement shall remain with PC;

                  12.1.5 PC shall,  at all times,  be the sole  employer  of the
         Physician  Employees,  the Other  Professional  Employees and all other
         professional  personnel  engaged by PC in connection with the operation
         of its  medical  practice  at  the  Facilities,  and  shall  be  solely
         responsible for the payment of all applicable  federal,  state or local
         withholding or similar taxes and provision of workers' compensation and
         disability insurance for such professional personnel;

                  12.1.6 No party  shall  have the right to  participate  in any
         benefits,  employment  programs or plans sponsored by the other parties
         on behalf of the other parties' employees,  including,  but not limited
         to, workers'  compensation,  unemployment  insurance,  tax withholding,
         health insurance,  life insurance,  pension plans or any profit sharing
         arrangement;


                                       23

<PAGE>



                  12.1.7 In no event  shall any party be liable for the debts or
         obligations  of  any  other  party  except  as  otherwise  specifically
         provided in this Agreement; and

                  12.1.8 Matters involving the internal  agreements and finances
         of PC,  including but not limited to the  distribution  of professional
         fee income among Physician  Employees and Other Professional  Employees
         who are  providing  professional  services to patients of PC, and other
         employees of PC, disposition of PC property and stock, accounting,  tax
         preparation,  tax planning,  and pension and  investment  planning (and
         expenses  relating solely to these internal business  matters),  hiring
         and  firing  of  physicians,  decisions  and  contents  of  reports  to
         regulatory  authorities  governing PC and  licensing,  shall remain the
         sole responsibility of PC.

         12.2 FORCE  MAJEURE.  No party shall be liable to the other for failure
to perform any of the services  required  under this Agreement in the event of a
strike,  lockout,  calamity,  act of God,  unavailability of supplies,  or other
event over which such party has not control, for so long as such event continues
and for a reasonable period of time thereafter, and in no event shall such party
be  liable  for  consequential,  indirect,  incidental  or like  damages  caused
thereby.

         12.3 USE OF NAME OF PC. The name or any statement  that may  implicitly
refer  directly  or  indirectly  to PC or impute  any  affiliation  directly  or
indirectly  between Management Company and PC shall not be used in any manner or
on behalf of Management  Company in any advertising or promotional  materials or
otherwise without PC's prior written consent.  However,  Management  Company may
use P.C's name or address in advertising to the public solely for the purpose of
providing directions to the office(s) of PC.

         12.4  EQUITABLE  RELIEF.   Without  limiting  other  possible  remedies
available to a  non-breaching  party for the breach of the  covenants  contained
herein, injunctive or other equitable relief shall be available to enforce those
covenants,  such relief to be without the  necessity  of posting  bond,  cash or
otherwise.  If any restriction  contained in said covenants is held by any court
to be unenforceable or unreasonable,  a lesser  restriction shall be enforced in
its place and remaining  restrictions therein shall be enforced independently of
each other.

         12.5 PRIOR AGREEMENTS;  AMENDMENTS. This Agreement supersedes all prior
agreements  and  understandings  between the  parties as to the  subject  matter
covered hereunder,  and this Agreement may not be amended,  altered,  changed or
terminated orally. No amendment,  alteration,  change or attempted waiver of any
of the  provisions  hereof shall be binding  without the written  consent of all
parties, and such amendment,  alteration, change, termination or waiver shall in
no way affect the other terms and  conditions  of this  Agreement,  which in all
other respects shall remain in full force.


                                       24

<PAGE>



         12.6  ASSIGNMENT;  BINDING  EFFECT.  This  Agreement and the rights and
obligations  hereunder may not be assigned  without the prior written consent of
all of the parties,  and any attempted  assignment without such consent shall be
void and of no force and effect,  except that Management Company may assign this
Agreement  to any  subsidiary  or affiliate of  Management  Company  without the
consent of the other parties.  The provisions of this Agreement shall be binding
upon and shall  inure to the benefit of the  parties'  respective  heirs,  legal
representatives, successors and permitted assigns.

         12.7 WAIVER OF BREACH.  The  failure to insist  upon strict  compliance
with any of the terms,  covenants  or  conditions  herein  shall not be deemed a
waiver  of such  terms,  covenants  or  conditions,  nor  shall  any  waiver  or
relinquishment  of any  right  at any one or more  times be  deemed a waiver  or
relinquishment of such right at any other time or times.

         12.8 GOVERNING  LAW. This Agreement  shall be governed by and construed
in  accordance  with the  laws of the  State of New  York.  Any and all  claims,
disputes,  or  controversies  arising under,  out of, or in connection with this
Agreement or any breach thereof,  except for equitable relief sought pursuant to
Section 11.4 hereof,  shall be determined by binding arbitration in the State of
New York,  County of New York  (hereinafter  "Arbitration").  The party  seeking
determination  shall  subject  any such  dispute,  claim or  controversy  to the
American Arbitration  Association,  New York County, and the rules of commercial
arbitration  of the  selected  entity shall  govern.  The  Arbitration  shall be
conducted  and decided by three (3)  arbitrators,  unless the  parties  mutually
agree,  in  writing at the time of the  Arbitration,  to fewer  arbitrators.  In
reaching a decision, the arbitrators shall have no authority to change or modify
any provision of this  Agreement,  including any liquidated  damages  provision.
Each party shall bear its own  expenses  and  one-half the expenses and costs of
the  arbitrators.  Any application to compel  Arbitration,  confirm or vacate an
arbitral award or otherwise  enforce this Section shall be brought in the Courts
of the State of New York or the United  States  District  Court for the Southern
District of New York, to whose  jurisdiction for such purposes PC and Management
Company hereby irrevocably consent and submit.

         12.9 SEPARABILITY. If any portion of the provisions hereof shall to any
extent be invalid or  unenforceable,  the  remainder of this  Agreement,  or the
application of such portion or provisions in  circumstances  other than those in
which it is held invalid or unenforceable,  shall not be affected  thereby,  and
each portion or provision of this  Agreement  shall be valid and enforced to the
fullest  extent  permitted by law, but only to the extent the same  continues to
reflect  fairly the intent and  understanding  of the parties  expressed by this
Agreement take as a whole.

         12.10  HEADINGS.  Section and  paragraph  headings are not part of this
Agreement  and are included  solely for  convenience  and are not intended to be
full or accurate descriptions of the contents thereof.


                                       25

<PAGE>



         12.11 NOTICES. Any notice hereunder shall have been deemed to have been
given only if in writing and either  delivered in hand or sent by  registered or
certified mail, return receipt requested,  postage prepaid,  or by United States
Express Mail or other commercial  expedited  delivery service,  with all postage
and delivery charges prepaid, to the addresses set forth below:

                  If to Management Company:

                           Gerardo Canet, President
                           IntegraMed America, Inc.
                           One Manhattanville Road
                           Purchase, New York 10577-2100

                  With a copy to:

                           Claude E. White, Esq.
                           General Counsel
                           IntegraMed America, Inc.
                           One Manhattanville Road
                           Purchase, New York 10577-2100

                  If to PC:

                           Gabriel San Roman, MD, President
                           MPD Medical Associates, P.C.
                           200 Old Country Road
                           Mineola, New York 11501

                  With a copy to:

                           Charles A. Bilich, Esq.
                           Meltzer, Lippe, Goldstein & Schlissel, P.C.
                           190 Willis Avenue
                           Mineola, New York 11501

Any party hereto, by like notice to the other parties,  may designate such other
address or addresses to which notice must be sent.

         12.12 ENTIRE  AGREEMENT.  This  Agreement  and all  attachments  hereto
represent  the entire  understanding  of the parties  hereto with respect to the
subject matter hereof and thereof, and cancel and supersede all prior agreements
and  understandings  among the parties  hereto,  whether  oral or written,  with
respect to such subject matter.


                                       26

<PAGE>



         12.13 NO MEDICAL  PRACTICE BY MANAGEMENT  COMPANY.  Management  Company
will not engage in any activity that  constitutes the practice of medicine,  and
nothing contained in this Agreement is intended to authorize  Management Company
to engage in the practice of medicine or any other licensed profession.

         12.14    CONFIDENTIAL INFORMATION.

                  12.14.1  During the initial  term and any  renewal  term(s) of
         this  Agreement,  the parties  may have access to or become  acquainted
         with each others' trade secrets and other  confidential  or proprietary
         knowledge  or  information  concerning  the conduct and details of each
         party's business ("Confidential Information").  At all times during and
         after the  termination  of this  Agreement,  no party shall directly or
         indirectly,   communicate,  disclose,  divulge,  publish  or  otherwise
         express to any individual or governmental or non-governmental entity or
         authority  (individually  and collectively  referred to as "Person") or
         use for its own benefit or the  benefit of any Person any  Confidential
         Information,  no matter how or when acquired,  of another  party.  Each
         party  shall  cause  each  of  its  employees  to  be  advised  of  the
         Confidential  nature of such  Confidential  Information and to agree to
         abide by the  confidentiality  terms of this Agreement.  No party shall
         photocopy  or  otherwise  duplicate  any  Confidential  Information  of
         another  party without the prior  express  written  consent of the such
         other  party  except as is  required  to  perform  services  under this
         Agreement. All such Confidential Information shall remain the exclusive
         property of the  proprietor  and shall be  returned  to the  proprietor
         immediately upon any termination of this Agreement.

                  12.14.2 Confidential Information shall not include information
         which (i) is or becomes known through no fault of a party hereto;  (ii)
         is learned by a party from a third-party  legally  entitled to disclose
         such information;  or (iii) was already known to a party at the time of
         disclosure by the disclosing party.

                  12.14.3 In order to minimize  any  misunderstanding  regarding
         what   information  is  considered  to  be  Confidential   Information,
         Management  Company or PC will  designate  at each  others  request the
         specific  information  which  Management  Company or PC considers to be
         Confidential Information.

         12.15    INDEMNIFICATION.

                  12.15.1  Management  Company  agrees  to  indemnify  and  hold
         harmless PC, its directors,  officers,  employees and servants from any
         suits,  claims,  actions,  losses,  liabilities or expenses  (including
         reasonable  attorney's  fees and costs) arising out of or in connection
         with any act or failure  to act by  Management  Company  related to the
         performance of its duties and  responsibilities  under this  Agreement.
         The  obligations  contained  in  this  Section  12.15.1  shall  survive
         termination of this Agreement.

                                       27

<PAGE>



                  12.15.2 PC agrees to indemnify  and hold  harmless  Management
         Company, its shareholders,  directors, officers, employees and servants
         from any  suits,  claims,  actions,  losses,  liabilities  or  expenses
         (including  reasonable  attorney's fees and costs) arising out of or in
         connection  with  any  act or  failure  to act by PC's  related  to the
         performance of its duties and  responsibilities  under this  Agreement.
         The  obligations  contained  in  this  Section  12.15.2  shall  survive
         termination of this Agreement.

                  12.15.3  In  the  event  of  any  claims  or  suits  in  which
         Management   Company  and/or  PC  and/or  their  directors,   officers,
         employees and servants are named, each of Management Company and PC for
         their respective directors,  officers,  employees agree to cooperate in
         the defense of such suit or claim; such cooperation  shall include,  by
         way of example but not limitation,  meeting with defense counsel (to be
         selected  by  the  respective  party  hereto),  the  production  of any
         documents in his/her  possession for review,  response to subpoenas and
         the  coordination  of any  individual  defense  with  counsel  for  the
         respective  parties  hereto.  The  respective  party shall,  as soon as
         practicable,  deliver to the other copies of any summonses, complaints,
         suit letters,  subpoenas or legal papers of any kind,  served upon such
         party,  for which  such party  seeks  indemnification  hereunder.  This
         obligation  to  cooperate  in the  defense of any such  claims or suits
         shall survive the termination, for whatever reason, of this Agreement.

                  12.15.4  Management  Company will defend,  indemnify  and hold
         harmless  the PC  against  and in  respect  of (i) any  and all  debts,
         liabilities  and  obligations of the PC accruing prior to the Effective
         Financial Date ["Prior PC  Liabilities"]  and (ii) any and all actions,
         suits, proceedings, claims, demands, assessments,  judgments, costs and
         expenses  (including fees and expenses of counsel)  arising out of such
         Prior PC Liabilities.

                  12.15.5  Promptly after the receipt by the PC of notice of any
         claim  or  commencement   of  any  action  or  proceeding   subject  to
         indemnification  delineated in Section 12.15.4 ("asserted  liability"),
         the PC will, demand such  indemnification  from Management  Company and
         proffer  the  defense to  Management  Company.  Management  Company may
         thereafter,  at its option,  assume such defense at its own expense and
         by its own counsel.  Management Company shall provide written notice to
         the PC, within twenty days, of its  assumption or  declination  of such
         defense.  If  Management  Company  shall  undertake to  compromise  any
         asserted liability, it shall promptly notify the PC of its intention to
         do so and the PC agrees to cooperate fully and promptly with Management
         Company and its counsel in the  compromise  and defense of any asserted
         liability.  Management  Company  shall not enter into any  non-monetary
         settlement  hereunder  without  the prior  written  consent  of the PC.
         Notwithstanding  the foregoing,  PC shall have the right to participate
         in the  compromise  or defense of any asserted  liability  with its own
         counsel and at its own expense.

                                       28

<PAGE>



         IN WITNESS  WHEREOF,  this  Agreement  has been executed by the parties
hereto as of the day and year first above written.


INTEGRAMED AMERICA, INC.




By:/s/Gerardo Canet
   ------------------------------
   Gerardo Canet, President & CEO




MPD MEDICAL ASSOCIATES, P.C.




By:/s/Gabriel San Roman
   ------------------------------------
   Gabriel San Roman, M.D., Shareholder



By:/s/Kristen Cain
   -----------------------------
   Kristen Cain, MD, Shareholder

                                       29

<PAGE>



                                   EXHIBIT 3.2


                              OFFICE AND FACILITIES
                   TO BE PROVIDED BY MANAGEMENT COMPANY TO PC



                  200 Old Country Road, Mineola, New York 11501

        2500 Nesconset Highway, Building #19, Stony Brook, New York 11790


































                                       30

<PAGE>


                                  EXHIBIT 6.3.2

                               SECURITY AGREEMENT


                                 [See Attached]




                                       31


                     AMENDMENT NO. 3 TO MANAGEMENT AGREEMENT

                                     BETWEEN

                            INTEGRAMED AMERICA, INC.

                                       AND

                  SHADY GROVE REPRODUCTIVE SCIENCE CENTER, P.C.



         THIS  AMENDMENT NO. 3 TO MANAGEMENT  AGREEMENT  ("Amendment  No. 3") is
dated  September  1, 1999 by and between  IntegraMed  America,  Inc., a Delaware
corporation,  with its principal place of business at One  Manhattanville  Road,
Purchase,  New York  10577("IntegraMed")  and Shady Grove  Reproductive  Science
Center, P.C., a Maryland professional corporation, having a place of business at
15001 Shady Grove Road, Suite 400, Rockville, Maryland 20850 ("Shady Grove").

                                    RECITALS:

         WHEREAS,  Shady  Grove  (formerly  known as Levy,  Sagoskin & Stillman,
M.D.,  P.C.) and Shady Grove  Fertility  Centers,  P.C.  ("PC")  entered  into a
management agreement dated March 11, 1998 pursuant to which PC agreed to provide
certain management and  administrative  services to Shady Grove (the "Management
Agreement"); and

         WHEREAS,  PC changed its name to "Shady Grove Fertility Centers,  Inc."
("New Shady  Grove") on March 12, 1998 and  IntegraMed  acquired the majority of
the stock of New Shady  Grove on March 12, 1998 and the  remaining  stock of New
Shady Grove on January 5, 1999; and

         WHEREAS,  New Shady Grove and IntegraMed,  entered into a submanagement
agreement ("Submanagement  Agreement"),  with PC's consent, dated March 12, 1998
pursuant   to  which   IntegraMed   agreed  to   perform   certain   duties  and
responsibilities of New Shady Grove under the Management Agreement; and

         WHEREAS, the Management Agreement was amended by amendments dated April
16, 1998 and May 6, 1998; and

         WHEREAS, New Shady Grove, a wholly-owned subsidiary of IntegraMed,  was
merged into IntegraMed on March 29, 1999; and

         WHEREAS, IntegraMed and Shady Grove desire to clarify certain terms and
conditions of the Management Agreement, as amended.


<PAGE>


         NOW THEREFORE,  in  consideration  of the mutual promises and covenants
herein contained,  and as contained in the Management Agreement,  IntegraMed and
Shady Grove agree as follows:

         1. As a  result  of the  merger  of New  Shady  Grove,  a  wholly-owned
subsidiary of  IntegraMed,  into  IntegraMed  effective  March 29, 1999, all the
rights and obligations of New Shady Grove under the Management  Agreement inured
to the benefit of IntegraMed,  as  successor-in-interest,  and the Submanagement
Agreement terminated by operation of law.

         2. Sections 3.1.2 (iii) and (iv) of The Management Agreement are hereby
deleted and the following are hereby substituted therefor,  retroactive to March
12, 1998:

                  "(iii)  to  receive   payments   from   insurance   companies,
                  prepayments  received  from  health  care  plans and all other
                  third-party payors, and patient deposits (for purposes of this
                  Agreement  patient deposits shall mean any payment in the form
                  of cash, note, check, money order or other instrument received
                  from a patient in advance of  services  being  rendered to the
                  patient which collectively shall be hereinafter referred to as
                  "Patient Deposits"); (iv) to take possession of and endorse in
                  the name of PC (and/or in the name of any  Physician  Employee
                  or Other Professional  Employee rendering Infertility Services
                  to  patients of PC) any Patient  Deposits  and notes,  checks,
                  money  orders,  and other  instruments  received in payment of
                  Receivables;"

             3. The Management  Agreement is hereby amended to add the following
new Section 7.2.3 to Article 7, retroactive to March 12, 1998:

                  "7.2.3  On or  before  the 15th  business  day of each  month,
                  Management  Company  shall  reconcile all shared risk receipts
                  and Patient Deposits,  as herein defined, of PC arising during
                  the previous calendar month and PC hereby pays,  transfers and
                  assigns to Management  Company,  and Management Company hereby
                  accepts from PC, all Patient  Deposits  hereafter  owned by or
                  arising in favor of PC during each such  previous  month.  All
                  Patient  Deposits  shall  be paid to  Management  Company,  in
                  consideration  of management  services in accordance with this
                  Article 7, subject to refund to PC in the event the applicable
                  Infertility  Services  for which the Patient  Deposit was paid
                  are not performed by PC.

             4. All other  provisions of the Management  Agreement,  as amended,
not in conflict with this Amendment No. 3 remain in full force and effect.

             5. This  Amendment  No. 3 may be executed in any number of separate
counterparts,  each of which shall be deemed to be an original, but all of which
together shall constitute one and the same instrument.






<PAGE>


             IN WITNESS  WHEREOF,  the parties have signed this  Amendment No. 3
the date first above written.


INTEGRAMED AMERICA, INC.



By:/s/Gerardo Canet
   ------------------------------
   Gerardo Canet, President & CEO




SHADY GROVE REPRODUCTIVE SCIENCE CENTER, P.C.



By:/s/Michael J. Levy
   --------------------------------
   Michael J. Levy, M.D., President




FLEET
CAPITAL LEASING

                                     MASTER EQUIPMENT LEASE AGREEMENT NO. 32793


LESSOR:  FLEET CAPITAL CORPORATION            LESSEE:   INTEGRAMED AMERICA, INC.
         A Rhode Island Corporation                     a Delaware Corporation

Address: 50 Kenndey Plaza                    Address:   One Manhattanville Rd.
         Providence, Rhode Island 02903-2305            Purchase, NY 10577-2100

1.   LEASE OF EQUIPMENT
     Subject to the terms and conditions  set forth herein (the "Master  Lease")
and in any Lease Schedule  incorporating the terms of this Master Lease {each, a
"Lease Schedule"),  Lessor agrees to lease to Lessee, and Lessee agrees to lease
from  Lessor,  the items and units of personal  property  described in each such
Lease Schedule,  together with all replacements,  parts, additions,  accessories
and substitutions  therefor  {collectively,  the  "Equipment").  As used in this
Lease, the term "Item of Equipment" shall mean each functionally  integrated and
separately  marketable  group or unit of Equipment  subject to this Lease.  Each
Lease Schedule shall  constitute a separate,  distinct and independent  lease of
Equipment and contractual obligation of Lessee. References to "the Lease," "this
Lease"  or "any  Lease"  shall  mean  and  refer  to any  Lease  Schedule  which
incorporates  the  terms of this  Master  Lease,  together  with  all  exhibits,
addenda,  schedules,  certificates,  riders and other  documents and instruments
executed and  delivered in  connection  with such Lease  Schedule or this Master
Lease,  all as the  same may be  amended  or  modified  from  time to time.  The
Equipment is to be delivered and installed at the location specified or referred
to in the applicable Lease Schedule.  The Equipment shall be deemed to have been
accepted by Lessee for all purposes under this Lease upon Lessor's receipt of an
Acceptance Certificate with respect to such Equipment,  executed by Lessee after
receipt  of all other  documentation  required  by Lessor  with  respect to such
Equipment. Lessor shall not be liable or responsible for any failure or delay in
the delivery of the  Equipment to Lessee for  whatever  reason.  As used in this
Lease, " Acquisition  Cost" shall mean (a) with respect to all Equipment subject
to a Lease Schedule,  the amount set forth as the Acquisition  Cost in the Lease
Schedule and the Acceptance  Certificate  applicable to such Equipment;  and {b)
with respect to any item of Equipment,  the total amount of all vendor or seller
invoices  (including  Lessee  invoices,  if any)  for  such  item of  Equipment,
together with all acquisition fees and costs of delivery, installation,  testing
and related services, accessories,  supplies or attachments procured or financed
by Lessor from vendors or suppliers thereof (including items provided by Lessee}
relating or allocable to such item of Equipment ("Related Expenses"). As used in
this Lease with respect to any Equipment,  the terms"  Acceptance Date," "Rental
Payment(s)," "Rental Payment Date(s)," "Rental Payment Numbers," "Rental Payment
Commencement  Date," "Lease Term" and "Lease Term Commencement  Date" shall have
the  meanings  and  values  assigned  to  them  in the  Lease  Schedule  and the
Acceptance Certificate applicable to such Equipment.

2.   TERM AND RENT
     The Lease Term for any  Equipment  shall be as specified in the  applicable
Lease  Schedule.  Rental  Payments  shall be in the amounts and shall be due and
payable  as set  forth  in the  applicable  Lease  Schedule.  Lessee  shall,  in
addition,  pay  interim  rent to Lessor on a pro-rata,  per-diem  basis from the
Acceptance Date to the Lease Term  Commencement Date set forth in the applicable
Acceptance  Certificate,  payable on such Lease Term  Commencement  Date. If any
rent or other amount payable  hereunder  shall not be paid within 10 days of the
date when due, Lessee shall pay as an  administrative  and late charge an amount
equal to1.5% of the amount of any such  overdue  payment.  In  addition,  Lessee
shall pay overdue interest on any delinquent  payment or other amounts due under
the Lease (by reason of  acceleration  or otherwise)  from 30 days after the due
date until paid at the rate of 1 1/2% per month or the maximum amount  permitted
by applicable law,  whichever is lower.  All payments to be made to Lessor shall
be made to Lessor in immediately  available funds at the address shown above, or
at such other  place as Lessor  shall  specify to Lessee in  writing.  THIS IS A
NON-CANCELABLE,  NON-  TERMINABLE  LEASE OF EQUIPMENT  FOR THE ENTIRE LEASE TERM
PROVIDED IN EACH LEASE SCHEDULE HERETO.

3.   POSSESSION; PERSONAL PROPERTY
     No right,  title or interest in the  Equipment  shall pass to Lessee  other
than the right to maintain  possession  and use of the  Equipment  for the Lease
Term (provided no Event of Default has occurred) free from  interference  by any
person claiming by, through,  or under Lessor. The Equipment shall always remain
personal  property even though the Equipment  may hereafter  become  attached or
affixed to real  property.  Lessee agrees to give and record such notices and to
take such other  action at its own  expense as may be  necessary  to prevent any
third party  (other than an assignee  of Lessor)  from  acquiring  or having the
right under any  circumstances  to acquire any interest in the Equipment or this
Lease.

<PAGE>

4.   DISCLAIMER OF WARRANTIES
     LESSOR IS NOT THE MANUFACTURER OR SUPPLIER OF THE EQUIPMENT, NOR THE AGEENT
THEREOF; AND MAKES NO EXPHESS OR IMPLIED REPRESENTATIONS OR WARRANTIES AS TO ANY
MATTER  WHATSOEVER,  INCLUDING WITHOUT  LIMITATION,  THE  MERCHANTABILITY OF THE
EQUIPMENT,  ITS FITNESS FOR A PARTICULAR PURPOSE,  ITS DESIGN OR CONDITION,  ITS
CAPACITY OR  DURABILITY,  THE  QUALITY OF THE  MATERIAL  OR  WORKMANSHIP  IN THE
MANUFACTURE OR ASSEMBLY OF THE EQUIPMENT,  OR THE CONFORMITY OF THE EQUIPMENT TO
THE PROVISIONS AND  SPECIFICATIONS  OF ANY PURCHASE ORDER RELATING  THERETO,  OR
PATENT INFRINGEMENTS,  AND LESSOR HEREBY DISCLAIMS ANY SUCH WARRANTY.  LESSOR IS
NOT RESPONSIBLE FOR ANY REPAIRS OR SERVICE TO THE EQUIPMENT,  DEFECTS THEREIN OR
FAILURES IN THE OPERATION THEREOF. Lessee has made the selection of each item of
Equipment and the manufacturer and/or supplier thereof based on its own judgment
and expressly disclaims any reliance upon any statements or representations made
by Lessor. For so long as no Event of Default (or event or condition which, with
the passage of time or giving of notice,  or both, would become such an Event of
Default) has occurred and is continuing, Lessee shall be the beneficiary of, and
shall be entitled to, all rights under any applicable manufacturer's or vendor's
warranties with respect to the Equipment, to the extent permitted by law.

     If the  Equipment is not  delivered,  is not properly  installed,  does not
operate as warranted,  becomes  obsolete,  or is  unsatisfactory  for any reason
whatsoever,  Lessee shall make all claims on account  thereof solely against the
manufacturer or supplier and not against Lessor,  and Lessee shall  nevertheless
pay all rentals  and other sums  payable  hereunder.  Lessee  acknowledges  that
neither  the   manufacturer  or  supplier  of  the  Equipment,   nor  any  sales
representative  or agent  thereof,  is an agent of Lessor,  and no  agreement or
representation  as to the  Equipment  or any  other  matter  by any  such  sales
representative  or agent of the manufacturer or supplier shall in any way affect
Lessee's obligations hereunder.

5.   REPRESENTATIONS, WARRANTIES AND COVENANTS
     Lessee represents and warrants to and covenants with Lessor that:

     (a) Lessee has the form of  business  organization  indicated  above and is
duly  organized and existing in good standing under the laws of the state listed
in the  caption  of this  Master  Lease  and is duly  qualified  to do  business
wherever necessary to carryon its present business and operations and to own its
property; (b) this Lease has been duly authorized by all necessary action on the
part of Lessee  consistent with its form of  organization,  does not require any
further  shareholder or partner  approval,  does not require the approval of, or
the  giving  notice  to,  any  federal,  state,  local or  foreign  governmental
authority and does not  contravene  any law binding on Lessee or contravene  any
certificate or articles of incorporation  or by-laws or partnership  certificate
or agreement,  or any agreement,  indenture, or other instrument to which Lessee
is a party or by which it may be bound;  (c} this  Lease has been duly  executed
and  delivered by  authorized  officers or partners of Lessee and  constitutes a
legal, valid and binding obligation of Lessee enforceable in accordance with its
terms; (d) Lessee has not and will not, directly or indirectly, create, incur or
permit to exist any lien, encumbrance,  mortgage, pledge, attachment or security
interest on or with  respect to the  Equipment  or this Lease  (except  those of
persons  claiming by, through or under  Lessor);  (e) the Equipment will be used
solely in the conduct of Lessee's business and will remain in the location shown
on the applicable  Lease Schedule unless Lessor  otherwise agrees in writing and
Lessee has completed all notifications, filings, recordings and other actions in
such new location as Lessor may reasonably  request to protect Lessor's interest
in the Equipment;  (f) there are no pending or threatened actions or proceedings
before any court or  administrative  agency which  materially  adversely  affect
Lessee's financial condition or operations,  and all credit, financial and other
information  provided  by  Lessee  or at  Lessee's  direction  is,  and all such
information  hereafter  furnished  will be accurate  and  complete in ~ material
respects;  and (g)  Lessor  has  not  selected,  manufactured  or  supplied  the
Equipment to Lessee and has  acquired any  Equipment  subject  hereto  solely in
connection with this Lease and Lessee has received and approved the terms of any
purchase order or agreement with respect to the Equipment.

<PAGE>

6.   INDEMNITY
     Lessee  assumes the risk of liability  for, and hereby  agrees ~O indemnify
and hold safe and harmless,  and  covenants to defend,  Lessor,  its  employees,
servants  and agents  from and  against:  (a) any and all  liabilities,  losses,
damages, claims and expenses (including legal expenses of every kind and nature)
arising out of the manufacture, purchase, shipment and delivery of the Equipment
to Lessee, acceptance or rejection,  ownership, titling, registration,  leasing,
possession,  operation,  use,  return  or other  disposition  of the  Equipment,
including,  without  limitation,  any liabilities  that may arise from patent or
latent defects in the Equipment  (whether or not  discoverable  by Lessee),  any
claims  based on absolute  tort  liability  or warranty  and any claims based on
patent,  trademark or copyright infringement;  (b) any and all loss or damage of
or to the Equipment;  and (c) any obligation or liability to the manufacturer or
any supplier of the  Equipment  arising  under any purchase  orders issued by or
assigned to Lessor .

7.   TAXES AND OTHER CHARGES
     Lessee agrees to comply with all laws,  regulations and governmental orders
related to this Lease and to the Equipment and its use or possession, and to pay
when due, and to defend and indemnify  Lessor against  liability for all license
fees, assessments,  and sales, use, property,  excise, privilege and other taxes
(including  any related  interest or  penalties} or other charges or fees now or
hereafter imposed by any governmental body or agency upon any Equipment, or with
respect to the manufacturing, ordering, shipment, purchase, ownership, delivery,
installation,  leasing, Operation, possession, use, return, or other disposition
thereof or the rentals  hereunder (other than taxes on or measured solely by the
net income of Lessor).  Any fees,  taxes or other lawful  charges paid by Lessor
upon failure of Lessee to make such  payments  shall at Lessor's  option  become
immediately due from Lessee to Lessor .

     If any Lease Schedule is denominated as a "True Lease Schedule," then, with
respect to the  Equipment set forth on such True Lease  Schedule.  Lessee hereby
covenants and agrees that Lessor shall be entitled to the following tax benefits
(the "Tax Benefits"),  Lessor will be entitled to cost recovery deductions under
Section 168 of the Internal Revenue Code of 1986, as amended (the "Code"), using
a 200% declining  balance method of depreciation  switching to the straight line
method for the first  taxable  year for which  such  method  will  yield  larger
depreciation  deductions,  and assuming a half-year  convention and zero salvage
value, for the applicable recovery period for such Equipment as set forth in the
True Lease Schedule with respect to such Equipment.  Lessee further acknowledges
and  agrees  that  Lessor  has  entered  into such True  Lease  Schedule  on the
assumption that Lessor will be taxed throughout the Lease Term of the True Lease
Schedule at Lessor's  federal  corporate income tax rate existing on the date of
such Lease.  Schedule (the" Assumed,  Tax Rate"). If, for any reason whatsoever,
there shall be a loss,  disallowance,  recapture or delay in claiming all or any
portion of the Tax  Benefits  with respect to the  Equipment,  or there shall be
included  in  Lessor's  gross  income  for  Federal,  state or local  income tax
purposes any amount on account of any addition,  modification  or improvement to
or in respect of any of the  Equipment  made or paid for by Lessee,  or if there
shall be a change in the  Assumed Tax Rate (any loss,  disallowance,  recapture,
delay,  inclusion or change being herein called a "Tax Loss"),  then thirty (30)
days  after  written  notice to Lessee by Lessor  that a Tax Loss has  occurred,
Lessee shall pay Lessor a lump sum amount  which,  after  deduction of all taxes
required to be paid by Lessor with respect to the receipt of such  amount,  will
provide Lessor with an amount necessary to maintain Lessor's  after-tax economic
yield and overall net after-tax cash flows at least at the same level that would
have  been  available  if such  Tax Loss had not  occurred,  plus any  interest,
penalties or additions to tax which may be imposed in  connection  with such Tax
Loss, In lieu of paying such Tax Loss in a lump sum, Lessor may require, or upon
Lessee's  request,  may agree, in Lessor's sole  discretion,  that such Tax Loss
shall be paid in equal  periodic  payments over the applicable  remaining  Lease
Term with  respect to such  Equipment  with each Rental  Payment due and payable
with respect to such Equipment.  A Tax Loss shall conclusively be deemed to have
occurred if either (a) a  deficiency  shall have been  proposed by the  Internal
Revenue  Service  or other  taxing  authority  having  jurisdiction,  or (b) tax
counsel  for Lessor has  rendered an opinion to Lessor that such Tax Loss has so
occurred.  The foregoing indemnities and covenants set forth in Sections 6 and 7
of this Master Lease shall  continue in full force and effect and shall  survive
the expiration or earlier termination of the Lease.

<PAGE>

8.   DEFAULT
     Lessee shall be in default of this Lease upon the  occurrence  of anyone or
more of the following events (each an "Event of Default"):

     (a) Lessee shall fail to make any payment, of rent or otherwise,  under any
Lease  within 200 days of the date when due; or (b) Lessee  shall fail to obtain
or maintain any of the insurance  required under any Lease;  or (c) Lessee shall
fail to perform or observe any covenant, condition or agreement under any Lease,
and such failure  continues for 10 days after notice  thereof to Lessee;  or (d)
Lessee  shall  default in the  payment or  perform3nce  of any  indebtedness  or
obligation  to  Lessor or any  affiliated  person,  firm or entity  controlling,
controlled  by or under  Common  control  with  Lessor,  under any  loan,  note,
security  agreement,  lease,  guaranty,  title  retention or  conditional  sales
agreement or any other instrument or agreement evidencing such indebtedness with
Lessor or such other affiliated  person,  firm or entity  affiliated with Lessor
and any applicable grace or cure period with respect thereto has expired; or (e)
any  representation  or warranty  made by Lessee  herein or in any  certificate,
agreement,  statement  or  document  now or  hereafter  furnished  to  Lessor in
connection  herewith,  including without limitation,  any financial  information
disclosed  to Lessor by  Lessee,  shall  prove to be false or  incorrect  in any
material  respect;  or (f) death or  judicial  declaration  of  incompetence  of
Lessee,  it an  individual;  the  commencement  of any  bankruptcy,  insolvency,
arrangement,   reorganization,   receivership,   liquidation  or  other  similar
proceeding by or against Lessee or any of its  properties or businesses,  or the
appointment of a trustee, receiver, liquidator or custodian for Lessee or any of
its  properties  of  business,  or if Lessee  suffers  the entry of an order for
relief under Title 11 of the United  States  Code;  or the making by Lessee of a
general assignment or deed of trust for the benefit of creditors,  or (g) Lessee
shall  default  in any  payment  or other  obligation  equal to or in  excess of
$100,000.00  to any third  party and any  applicable  grace or cure  period with
respect  thereto has expired;  or (h) Lessee shall  terminate  its  existence by
merger, consolidation,  sale of substantially all of its assets or otherwise; or
(i) if Lessee is a  privately  held  corporation,  and more than 50% of Lessee's
voting capital  stock,  or effective  control of Lessee's  voting capital stock,
issued and outstanding from time to time, is not retained by the holders of such
stock  on the  date  of  this  Lease;  or  (j)  if  Lessee  is a  publicly  held
corporation,  there shall be a change in the ownership of Lessee's  stock.  such
that Lessee is no longer subject to the reporting requirements of the Securities
Exchange Act of 1934, or no longer has a class of equity  securities  registered
under  Section 12 of the  Securities  Act of 1933; or (k) any event or condition
set forth in  subsections  (b)  through  (j) of this  Section 8 shall occur with
respect to any guarantor or other person  responsible,  in whole or in part, for
payment or performance  of this Lease;  or (I) any event or condition set f<?rth
in  subsections  (d)  through  (j) sha~1  occur with  respect to any  affiliated
person, firm or entity  controlling,  controlled by or under common control with
Lessee.  Lessee shall  promptly  notify Lessor of the occurrence of any Event of
Default or the occurrence or existence of any event or condition which, upon the
giving of notice of lapse of time, or both, may become an Event of Default.

9.   REMEDIES: MANDATORY PREPAYMENT.
     Upon the occurrence of any Event of Default, Lessor may, at its sole option
and discretion,  exercise one or more of the following  remedies with respect to
any or all of the Equipment:  (a) cause Lessee to promptly  return,  at Lessee's
expense,  any or all  Equipment  to such  location  as Lessor may  designate  in
accordance with the terms of Section 18 of this Master Lease, or Lessor,  at its
option,  may enter upon the  premises  where the  Equipment  is located and take
immediate possession of and remove the same by summary proceedings or otherwise,
all without  liability  to Lessor for or by reason of damage to property or such
entry or taking  possession  except for  Lessor's  gross  negligence  or willful
misconduct; (b) sell any or all Equipment at public or private sale or otherwise
dispose of, hold, use, operate, lease to others or keep idle the Equipment,  all
as Lessor in its sole  discretion  may  determine  and all free and clear of any
rights  of  Lessee;  (c)  remedy  such  default,  including  making  repairs  or
modifications  to the  Equipment,  for the account  and  expense of Lessee,  and
Lessee agrees to reimburse Lessor for all of Lessor's costs and expenses; (d) by
written  notice to Lessee,  terminate the Lease with respect to any or all Lease
Schedules and the Equipment subject thereto, as such notice shall specify,  and,
with  respect  to  such  terminated  Lease  Schedules  and  Equipment,   declare
immediately due and payable and recover from Lessee,  as liquidated  damages for
loss of Lessor's bargain and not as a penalty, an amount equal to the Stipulated
Loss Value,  calculated as of the next following  Rental Payment Date; (e) apply
any  deposit or other cash  collateral  or sale or  remarketing  proceeds of the
Equipment at any time to reduce any amounts due to Lessor,  and (f) exercise any
other right or remedy which may be available to Lessor under  applicable law, or
proceed by  appropriate  court  action to enforce the terms hereof or to recover
damages for the breach hereof,  including  reasonable  attorneys' fees and court
costs.  Notice of Lessor's  intention  to  accelerate,  notice of  acceleration,
notice of nonpayment,  presentment,  protest,  notice of dishonor,  or any other
notice  whatsoever  are  hereby  waived by Lessee and any  endorser,  guarantor,
surety or other party liable in any capacity for any of the Lessee's obligations
under or in respect of the Lease.  No remedy referred to in this Section 9 shall
be exclusive,  but each shall be cumulative  and in addition to any other remedy
referred to above or otherwise available to Lessor at law or in equity.

<PAGE>

     The exercise or pursuit by Lessor of anyone or more of such remedies  shall
not preclude the  simultaneous  or later exercise or pursuit by Lessor of any or
all such other remedies, and all remedies hereunder shall survive termination of
this Lease. At any sale of the Equipment pursuant to this Section 9, Lessor may,
to the extent permitted by law, bid for the Equipment.  Notice required, if any,
of any sale or other  disposition  hereunder by Lessor shall be satisfied by the
mailing of such  notice to Lessee at least  seven (7) days prior to such sale or
other  disposition.  In the event  Lessor takes  possession  and disposes of the
Equipment,  the  proceeds  of any  such  disposition  shall  be  applied  in the
following order: (1} to all of Lessor's costs,  charges and expenses incurred in
taking, removing,  holding,  repairing and selling or leasing the Equipment; (2)
to the extent not previously paid by Lessee,  to pay Lessor for any damages then
remaining unpaid hereunder; (3) to reimburse Lessee for any sums previously paid
by Lessee as damages hereunder;  and (4) the balance,  if any, shall be retained
by Lessor. A termination shall occur only upon written notice by Lessor and only
with  respect  to such  Equipment  as  Lessor  shall  specify  in  such  notice.
Termination  under  this  Section 9 shall not  affect  Lessee's  duty to perform
Lessee's  obligations  hereunder to Lessor in full.  Lessee  agrees to reimburse
Lessor  on  demand  for any and all costs  and  expenses  incurred  by Lessor in
enforcing its rights and remedies hereunder following the occurrence of an Event
of Default, including,  without limitation,  reasonable attorney's fees, and the
costs of repossession,  storage, insuring,  reletting,  selling and disposing of
any and all Equipment.

     The term  "Stipulated  Loss  Value" with  respect to any item of  Equipment
shall mean the Stipulated  Loss Value as set forth in any Schedule of Stipulated
Loss Values  attached to and made a part of the applicable  Lease  Schedule.  If
there is no such Schedule of Stipulated  Loss Values,  then the Stipulated  Loss
Value with respect to any item of  Equipment  on any Rental  Payment Date during
the Lease Term shall be an amount  equal to the sum of: (a) all Rental  Payments
and other  amounts then due and owing to Lessor under the Lease,  together  with
all accrued interest and late charges thereon  calculated  through and including
the date of  payment;  ~ (b} the net present  value of: (i} all Rental  Payments
then  remaining  unpaid for the Lease  Term,  ~ (ii) the amount of any  purchase
obligation  with  respect  to such  item of  Equipment  or,  if there is no such
obligation,  then the fair market  value of such item of Equipment at the end of
the Lease Term, as estimated by Lessor in its sole  discretion  (accounting  for
the amount of any unpaid  Related  Expenses for such item of Equipment and, with
respect to any such item of Equipment  that has been attached to or installed on
or in any  other  property  leased  or  owned by  Lessee,  such  value  shall be
determined on an installed  basis,  in place and in use),  all discounted to net
present value at a discount rate equal to the 1-year Treasury  Constant Maturity
rate as published in the Selected  Interest  Rates table of the Federal  Reserve
statistical  release H.  15(519)  for the week ending  immediately  prior to the
original Acceptance Date for such Equipment.

10.  ADDITIONAL SECURITY
     For so long as any obligations of Lessee shall remain outstanding under any
Lease,  Lessee  hereby  grants to Lessor a security  interest in all of Lessee's
rights in and to  Equipment  subject to such Lease from time to time,  to secure
the  prompt  payment  and  performance  when due (by reason of  acceleration  or
otherwise) of each and every indebtedness, obligation or liability of Lessee, or
any  affiliated  person,  firm, or entity  controlling,  controlled by, or under
common control with Lessee,  owing to Lessor,  whether now existing or hereafter
arising,  including  but not  limited  to all of such  obligations  under  or in
respect of any Lease.  The extent to which  Lessor  shall have a purchase  money
security  interest  in any item of  Equipment  under a Lease  which is deemed to
create a security  interest  under Section 1-201 (37) of the Uniform  Commercial
Code shall be  determined  by  reference  to the  Acquisition  Cost of such item
financed by Lessor.  In order more fully to secure its rental  payments  and all
other obligations to Lessor hereunder, Lessee hereby grants to Lessor a security
interest  in any  deposit of Lessee to Lessor  under  Section  3(d) of any Lease
Schedule  hereto.  Such  security  deposit  shall  not  bear  interest,  may  be
commingled  with other  funds of Lessor  and shall be  immediately  restored  by
Lessee if applied under Section 9. Upon expiration of the term of this Lease and
satisfaction  of all of Lessee's  obligations,  the  security  deposit  shall be
returned to Lessee.  The term  "Lessor" as used in this Section 10 shall include
any affiliated person, firm or entity controlling, controlled by or under common
control with Lessor .

11.  NOTICES
     Any notices or demands  required or  permitted to be given under this Lease
shall be given in writing and by regular  mail and shall become  effective  when
deposited  in the  United  States  mail with  postage  prepaid  to Lessor to the
attention of Customer Accounts, and to Lessee at the address set forth above, or
to such other  address as the party to receive  notice  hereafter  designates by
such written notice.

<PAGE>

12.  USE; MAINTENANCE; INSPECTION; LOSS AND DAMAGE
     During  the Lease Term for each item of  Equipment,  Lessee  shall,  unless
Lessor shall otherwise consent in writing.  (a) permit each item of Equipment to
be used only within the continental United States by qualified  personnel solely
for business  purposes  and the purpose for which it was designed and shall,  at
its sole expense,  service, repair, overhaul and maintain each item of Equipment
in the same condition as when received, ordinary wear and tear excepted, in good
operating  order,  consistent with prudent  industry  practice (but, in no event
less than the same extent to which Lessee  maintains other similar  equipment in
the prudent  management of its assets and properties) and in compliance with all
applicable  laws,  ordinances,  regulations,  and  conditions  of all  insurance
policies  required to be  maintained  by Lessee under the Lease and all manuals,
orders,  recommendations,  instructions and other written requirements as to the
repair  and  maintenance  of such  item of  Equipment  issued at any time by the
vendor and/or manufacturer thereof; (b) maintain  conspicuously on any Equipment
such labels,  plates, decals or other markings as Lessor may reasonably require,
stating  that  Lessor is owner of such  Equipment;  (c)  furnish to Lessor  such
information  concerning  the  condition,  location,  use  and  operation  of the
Equipment as Lessor may request;  (d) permit any person  designated by Lessor to
visit and  inspect  any  Equipment  and any  records  maintained  in  connection
therewith,  during  normal  business  hours and upon prior  notice from Lessor ,
provided,  however,  that the failure of Lessor to inspect the  Equipment  or to
inform  Lessee  of any  noncompliance  shall  not  relieve  Lessee of any of its
obligations   hereunder;   (e)  if  any  Equipment  does  not  comply  with  the
requirements of this Lease,  Lessee shall, within 30 days of written notice from
Lessor,  bring such Equipment into  compliance;  (f) not use any Equipment,  nor
allow the same to be used, for any unlawful purpose,  nor in connection with any
property or material that would  subject the Lessor to any  liability  under any
state or federal statute or regulation pertaining to the production,  transport,
storage, disposal or discharge of hazardous or toxic waste or materials; and (g)
make no additions,  alterations,  modifications  or improvements  (collectively,
"Improvements")  to any item of Equipment that are not readily removable without
causing material damage to such item of Equipment or which will cause the value,
utility or useful life of such item of Equipment to materially  decline.  If any
such  Improvement is made and cannot be removed without causing  material damage
or decline in value,  utility or useful  life (a  "Non-Severable  Improvement"),
then Lessee  warrants that such Non-  Severable  Improvement  shall  immediately
become Lessor's property upon being installed and shall be free and clear of all
liens and encumbrances  and shall become  Equipment  subject to all of the terms
and conditions of the Lease. All such  Improvements  that are not  Non-Severable
Improvements  shall be  removed  by  Lessee  prior to the  return of the item of
Equipment hereunder or such Improvements shall also become the sole and absolute
property of Lessor without any further  payment by Lessor to Lessee and shall be

free and clear of all liens and encumbrances whatsoever. Lessee shall repair all
damage to any item of Equipment  caused by the removal of any  Improvement so as
to restore such item of Equipment to the same  condition  which existed prior to
its installation and as required by this Lease.

     Lessee hereby assumes all risk of loss,  damage or destruction for whatever
reason to the Equipment  from and after the earlier of the date (i) on which the
Equipment  is ordered or (ii) Lessor pays the purchase  price of the  Equipment,
and continuing until the Equipment has been returned to, and accepted by, Lessor
in the condition  required by Section 18 hereof upon the expiration of the Lease
Term. If during the Lease Term all or any portion of an item of Equipment  shall
become lost, stolen,  destroyed,  damaged beyond repair or rendered  permanently
unfit for use for any reason, or in the event of any condemnation, confiscation,
theft or seizure or  requisition  of title to or use of such item,  Lessee shall
immediately  pay to Lessor an amount equal to the Stipulated  Loss Value of such
item of Equipment, as of the next following Rental Payment Date.

<PAGE>

13.  INSURANCE
     Lessee shall  procure and maintain  insurance in such amounts and upon such
terms and with such  companies  as Lessor may  approve,  during the entire Lease
Term and until the  Equipment  has been  returned to, and accepted by, Lessor in
the condition required by Section 18 hereof, at Lessee's expense,  provided that
in no event  shall  such  insurance  be less than the  following  coverages  and
amounts: (a) Worker's  Compensation and Employer's  Liability Insurance,  in the
full statutory  amounts  provided by law; {b)  Comprehensive  General  Liability
Insurance  including  product/completed  operations  and  contractual  liability
coverage,  with  minimum  limits of $1 ,000,000  each  occurrence,  and Combined
Single  Limit Body Injury and  Property  Damage,  $1 ,000,000  aggregate,  where
applicable; and (c) All Risk Physical Damage Insurance, including earthquake and
flood, on each item of Equipment,  in an amount not less than the greater of the
Stipulated  Loss Value of the Equipment or (if available)  its full  replacement
value.  Lessor will be included as an  additional  insured and loss payee as its
interest  may  appear.  Such  policies  shall be  endorsed  to provide  that the
coverage  afforded to Lessor shall not be rescinded,  impaired or invalidated by
any act or neglect  of Lessee.  Lessee  agrees to waive  Lessee's  right and its
insurance carrier's rights of subrogation against Lessor for any and all loss or
damage.

     All policies shall be endorsed or contain a clause requiring the insurer to
furnish  Lessor  with at least 30 days'  prior  written  notice of any  material
change,  cancellation or non-renewal of coverage.  Upon execution of this Lease,
Lessee shall furnish  Lessor with a certificate  of insurance or other  evidence
satisfactory  to Lessor that such  insurance  coverage is in effect.  In case of
failure  of Lessee to procure or  maintain  insurance,  Lessor may at its option
obtain  such  insurance,  the  cost of  which  will be  paid  by the  Lessee  as
additional  rentals.  Lessee  hereby  irrevocably  appoints  Lessor as  Lessee's
attorney-in-fact  to file, settle or adjust, and receive payment of claims under
any such insurance policy and to endorse Lessee's name on any checks,  drafts or
other  instruments  on payment of such  claims.  Lessee  further  agrees to give
Lessor  prompt  notice of any  damage to or loss of the  Equipment,  or any part
thereof.

14.  LIMITATION OF LIABILITY
     Lessor  shall have no liability  in  connection  with or arising out of the
ownership,  leasing,  furnishing,  performance  or use of the  Equipment  or any
special,  indirect,  incidental  or  consequential  damages  of  any  character,
including,   without  limitation,  loss  of  use  of  production  facilities  or
equipment, loss of profits, property damage or lost production, whether suffered
by Lessee or any third party.

15.  FURTHER ASSURANCES
     Lessee shall promptly execute and deliver to Lessor such further  documents
and take such further action as Lessor may require in order to more  effectively
carry out the intent and purpose of this Lease.  Lessee shall provide to Lessor,
within 120 days after the close of each of  Lessee's  fiscal  years,  and,  upon
Lessor's request,  within 45 days of the end of ec.ch quarter of Lessee's fiscal
year, a copy of its financial  statements  prepared in accordance with generally
accepted accounting principles and, in, the case of annual financial statements,
audited  by  independent  certified  public  accountants,  and  in the  case  of
quarterly  financial  statements  certified by Lessee's chief financial officer.
Lessee  shall  execute and deliver to Lessor upon  Lessor's  request any and all
schedules,  forms and other reports and information as Lessor may deem necessary
or  appropriate  to  respond  to  requirements  or  regulations  imposed  by any
governmental  authorities.  Lessee  shall  execute  and  deliver to Lessor  upon
Lessor's  request  such  further  and  additional  documents,   instruments  and
assurances as Lessor deems  necessary (a) to  acknowledge  and confirm,  for the
benefit of Lessor or any assignee or transferee of any of Lessor's rights, title
and interests hereunder {an "Assignee"),  all of the terms and conditions of all
or any part of this  Lease  and  Lessor's  or  Assignee's  rights  with  respect
thereto, and Lessee's compliance with all of the terms and provisions hereof and
(b) to preserve,  protect and perfect  Lessor's or  Assignee's  right,  title or
interest hereunder and in any Equipment, including, without limitation, such UCC
financing  statements or  amendments,  corporate  resolutions,  certificates  of
compliance,  notices of assignment or transfers of interests,  and  restatements
and  reaffirmations  of  Lessee's   obligations  and  its   representations  and
warranties with respect thereto as of the dates requested by Lessor from time to
time.  In  furtherance  thereof,  Lessor  may  file or  record  this  Lease or a
memorandum  or a  photocopy  hereof  (which  for the  purposes  hereof  shall be
effective as a financing  statement) so as to give notice to third parties,  and
Lessee hereby appoints Lessor as its attorney-in-fact to execute, sign, file and
record UCC  financing  statements  and other  lien  recordation  documents  with
respect to the Equipment  where Lessee fails or refuses to do so after  Lessor's
written  request,  and Lessee agrees to payor  reimburse  Lessor for any filing,
recording or stamp fees or taxes arising from any such filings.

<PAGE>

16.  ASSIGNMENT
     This Lease and all rights of Lessor hereunder shall be assignable by Lessor
absolutely or as security,  without  notice to Lessee,  subject to the rights of
Lessee  hereunder for the use and  possession of the Equipment for so long as no
Event of Default has occurred and is continuing  hereunder . Any such assignment
shall  not  relieve  Lessor of its  obligations  hereunder  unless  specifically
assumed  by the  assignee,  and Lessee  agrees it shall not assert any  defense,
rights of set-off or  counterclaim  against any  assignee to which  Lessor shall
have  assigned its rights and interests  hereunder,  nor hold or attempt to hold
such  assignee  liable  for  any of  Lessor's  obligations  hereunder.  No  such
assignment shall materially  increase  Lessee's  obligations  hereunder.  LESSEE
SHALL NOT ASSIGN OR DISPOSE OF ANY OF ITS RIGHTS OR OBLIGATIONS UNDER THIS LEASE
OR ENTER INTO ANY  SUBLEASE  WITH  RESPECT TO ANY OF THE  EQUIPMENT  WITHOUT THE
EXPRESS PRIOR WRITTEN CONSENT OF LESSOR.

17.  LESSEE'S OBLIGATION UNCONDITIONAL
     This Lease is a net lease and  Lessee  hereby  agrees  that it shall not be
entitled to any abatement of rents or of any other amounts payable  hereunder by
Lessee,  and that its  obligation  to pay all rent and any other  amounts  owing
hereunder  shall  be  absolute  and  unconditional   under  all   circumstances,
including,  without limitation,  the following  circumstances:  (i) any claim by
Lessee to any right of set-off, counterclaim, recoupment, defense or other right
which  Lessee  may have  against  Lessor,  any  seller  or  manufacturer  of any
Equipment or anyone else for any reason  whatsoever;  (ii) the  existence of any
liens,  encumbrances  or  rights  of  others  whatsoever  with  respect  to  any
Equipment,  whether or not resulting  from claims  against Lessor not related to
the  ownership  of such  Equipment;  or (iii) any other  event or  circumstances
whatsoever.  Each Rent Payment or other amount paid by Lessee hereunder shall be
final and Lessee will not seek to recover all or any part of such  payment  from
Lessor for any reason whatsoever.

18.  RETURN OF EQUIPMENT
     Upon the  expiration or earlier  termination of the Lease Term with respect
to any  Equipment,  and  provided  that  Lessee has not  validly  exercised  any
purchase option with respect thereto,  Lessee shall: (a) return the Equipment to
a location and in the manner  designated  by the Lessor  within the  continental
United  States,   including,   as  reasonably   required  by  Lessor,   securing
arrangements  for the  disassembly  and  packing for  shipment by an  authorized
representative of the manufacturer of the Equipment, shipment with all parts and
pieces on a carrier  designated  or  approved  by  Lessor,  and then  reassembly
(including,  if necessary,  repair and overhaul) by such  representative  at the
return  location in the  condition the Equipment is required to be maintained by
the Lease and in such condition as will make the Equipment  immediately  able to
perform all functions for which the  Equipment  was  originally  designed (or as
upgraded   during  the  Lease  Term),   and   immediately   qualified   for  the
manufacturer's (or other authorized servicing  representative's)  then-available
service  contract  or  warranty;  (b) cause the  Equipment  to  qualify  for all
applicable  licenses or permits  necessary  for its  operation  for its intended
purpose and to comply with all  specifications  and  requirements  of applicable
federal,  state and local laws,  regulations and  ordinances;  (c) upon Lessor's
request, provide suitable storage, acceptable to Lessor, for the Equipment for a
period  not to  exceed 1 80 days from the date of  return;  (d)  cooperate  with
Lessor  in  attempting  to  remarket  the  Equipment,   including   display  and
demonstration  of the  Equipment  to  prospective  purchasers  or  lessees,  and
allowing  Lessor to  conduct  any  private  or  public  sale or  auction  of the
Equipment on Lessee's premises. All costs incurred in connection with any of the
foregoing shall be the sole  responsibility of the Lessee.  During any period of
time from the expiration or earlier termination of the Lease until the Equipment
is returned or put into  storage in  accordance  with the  provisions  hereof or
until  Lessor  has  been  paid  the  applicable  purchase  option  price  if any
applicable  purchase  option  is  exercised,  Lessee  agrees  to pay  to  Lessor
additional per diem rent  ("Holdover  Rent"),  payable  promptly on demand in an
amount equal to 125% of the highest  monthly Rental  Payment  payable during the
Lease Term divided by 30, provided,  however,  that nothing contained herein and
no payment of Holdover Rent hereunder  shall relieve Lessee of its obligation to
return the Equipment upon the expiration or earlier termination of the Lease.

19.  RELATED LEASE SCHEDULES
     In the event that any  Equipment  subject to a Lease shall become  attached
to, affixed to, or used in connection with Equipment  subject to any other Lease
hereunder (each a "Related Lease  Schedule"),  Lessee agrees that: (a) if Lessee
elects to exercise  any  purchase  option,  early  termination  option,  renewal
option,  purchase obligation or early purchase option under any Lease; or (b) if
Lessee elects to return the Equipment  under any Lease in accordance  therewith,
then, in either case, Lessor shall have the right, in its discretion, to require
the same disposition for all Equipment subject to a Related Lease Schedule.

<PAGE>

20.  MISCELLANEOUS; ENFORCEABILITY AND GOVERNING LAW.
     The term  "Lessee"  as used in the Lease shall mean and include any and all
Lessees who sign below, each of whom shall be jointly and severally liable under
the Lease.  This Master Lease will not be binding on Lessor  until  accepted and
executed by Lessor,  notice of which is hereby  waived by Lessee.  Any waiver of
the terms hereof shall be  effective  only in the specific  instance and for the
specific purpose given. Time is of the essence in the payment and performance of
all of Lessee's  obligations under the Lease. The captions in this Lease are for
convenience only and shall not define or limit any of the terms hereof .

     Any provisions of this Lease which are  unenforceable  in any  jurisdiction
shall,  as  to  such  jurisdiction,   be  ineffective  to  the  extent  of  such
unenforceability  without  invalidating the remaining provisions hereof, and any
such  unenforceability  in any jurisdiction shall not render  unenforceable such
provisions in any other jurisdiction. To the extent permitted by applicable law,
Lessee  hereby  waives;  (a) any  provisions  of law which render any  provision
hereof  unenforceable  in any respect;  (b) all rights and remedies  under Rhode
Island General Laws Sections 6A-2. 1-508 through 522 or corresponding provisions
of the  Uniform  Commercial  Code  article or  division  pertaining  to personal
property  leasing  in any  jurisdiction  in which  enforcement  of this Lease is
sought.

     THIS  LEASE AND THE LEGAL  RELATIONS  OF THE  PARTIES  HERETO  SHALL IN ALL
RESPECTS BE GOVERNED BY AND CONSTRUED IN  ACCORDANCE  WITH THE LAWS OF THE STATE
OF RHODE  ISLAND,  WITHOUT  REGARD TO  PRINCIPLES  REGARDING  THE CHOICE OF LAW.
LESSEE HEREBY CONSENTS AND SUBMITS TO THE JURISDICTION OF THE COURTS OF THE ST A
TE OF RHODE  ISLAND AND THE  FEDERAL  DISTRICT  COURT FOR THE  DISTRICT OF RHODE
ISLAND FOR THE PURPOSES OF ANY SUIT,  ACTION OR OTHER PROCEEDING  ARISING OUT OF
ITS OBLIGATIONS HEREUNDER,  AND EXPRESSLY WAIVES ANY OBJECTIONS THAT IT MAY HAVE
TO THE VENUE OF SUCH COURTS. LESSEE HEREBY EXPRESSL Y W AIVES ANY RIGHT TO TRIAL
BY JURY IN ANY ACTION  BROUGHT ON OR WITH  RESPECT TO THIS LEASE.  Any action by
Lessee  against  Lessor for any cause of action  relating to this Lease shall be
brought within one year after any such cause of action first arises.

     THIS LEASE  REPRESENTS THE FINAL AGREEMENT  BETWEEN THE PARTIES  CONCERNING
THE LEASE OF THE  EQUIPMENT  AND MAY NOT BE  CONTRADICTED  BY EVIDENCE OF PRIOR,
CONTEMPORANEOUS  OR  SUBSEQUENT  ORAL  AGREEMENTS  BETWEEN THE  PARTIES.  LESSEE
ACKNOWLEDGES  AND CERTIFIES THAT NO SUCH ORAL AGREEMENTS  EXIST.  THIS LEASE MAY
NOT BE  AMENDED,  NOR MAY ANY  RIGHTS  UNDER THE LEASE BE  WAIVED,  EXCEPT BY AN
INSTRUMENT IN WRITING SIGNED BY THE PARTY CHARGED WITH SUCH AMENDMENT OR
WAIVER.

Executed and delivered by duly authorized  representatives of the parties hereto
as of the date set forth below.

DA TED AS OF: NOVEMBER 30, 1998

FLEET CAPITAL CORPORATION                   INTEGRAMED AMERICA, INC.

By:    /s/J. Scott Sibley                   By:    /s/Gerardo Canet
       ------------------                          ----------------
Name:  J. Scott Sibley                      Name:  Gerardo Canet
Title: Vice President                       Title: President & CEO



<PAGE>


           FLEET
Capital Leasing

                                                 LEASE SCHEDULE NO. 32793-00001

50 Kennedy Plaza
Providence, Rhode Island 02903-2305

                                            Lessee:    INTEGRAMED AMERICA, INC.
                                           Address:    One Manhattanville Road
                                                       Purchase, NY 10577-2100

     1. This  Lease  schedule  No.  32793-00001  dated as of March  26,  1999 is
entered into pursuant to and  incorporates by this  reference,  all of the terms
and provisions of that certain Master  Equipment Lease Agreement No. 32793 dated
as of November 30, 1998 (the  "Master  Lease"),  for the lease of the  Equipment
described in schedule A attached hereto.  This Lease Schedule shall constitute a
separate,  distinct and  independent  lease of the Equipment and the contractual
obligation  of Lessee.  References to the "the Lease" or "this Lease" shall mean
and  refer to this  Lease  Schedule,  together  with the  Master  Lease  and all
exhibits,  addenda,  schedules,  certificates,  riders and other  documents  and
instruments  executed and delivered in connection with this Lease Schedule,  all
as the same may be amended or modified from time to time. All capitalized  terms
used herein and not defined herein shall have the meanings set forth or referred
to in the Master  Lease.  By it execution  and delivery of this Lease  Schedule,
Lessee hereby  reaffirms all of the  representations,  warranties  and covenants
contained in the Master Lease, as of the date hereof, and further represents and
warrants  to Lessor that no event of Default,  and no event or  condition  which
with notice or the passage of time or both would constitute an Event of Default,
has occurred and is continuing as of the date hereof.

     2. Acquisition Cost. The Acquisition Cost of the Equipment is $531,773.48.

     3. (a) LEASE  TERM.  The Lease Term shall  commence  on the date hereof and
shall continue for a period of 48 months after the Lease Term  Commencement  set
forth in the Acceptance  Certificate to his Lease Schedule,  plus any renewal or
extended term applicable in accordance with the terms of the Lease.

        (b) RENTAL  PAYMENTS.  In addition to interim rent  payable  pursuant to
Section 2 of the Master  Lease,  Lessee shall pay Lessor 48  consecutive  Rental
Payments in the amounts set forth in the  schedule  below,  plus any  applicable
sales/use taxes, commencing on the Rental Payment Commencement Date set forth in
the Acceptance  Certificate and MONTHLY thereafter for the remaining Lease Term.
Each Rental  Payment shall be payable on the same day of the month as the Rental
Payment Date in each  succeeding  rental period during the remaining  Lease Term
(each, a "Rental Payment Date"):

                                                       Amount of Each
         Number of Rental Payments                    Rental Payment

                   48                                   $12,896.15

        (c) ADVANCE RENTAL PAYMENT. Lessee agrees to pay Lessor the first 01 and
last 0 rental Payments, due and payable on the Acceptance Date.

        (d) SECURITY DEPOSIT. Lessee agrees to make a payment in an amount equal
to 0% of  the  Acquisition  Cost  of  the  Equipment,  due  and  payable  on the
Acceptance  Date,  to be held by Lessor as a  non-interest  bearing  deposit  to
secure Lessee's performance under the Lease.

     4. EQUIPMENT LOCATION(S).  The Equipment will be located at the location(s)
specified in Schedule A.

     5. Taxes.  Lessor will invoice  Lessee for all sales,  use and/or  personal
property taxes as and when due and payable in accordance  with  applicable  law,
unless Lessee delivers to Lessor a valid exemption  certificate  with respect to
such   taxes.   Delivery  of  such   certificate   shall   constitute   Lessee's
representation and warranty that no such taxes shall become due and payable with
respect to the Equipment,  and Lessee shall  indemnify and held harmless  Lessor
from and against any and all  liability or damages,  including  late charges and
interest which lessor may incur by reason of the assessment of such taxes.

     6. The Rental  Payments may change for Equipment  accepted  after APRIL 05,
1999.

<PAGE>

     7. EARLY TERMINATION. Upon at least 90 days prior written notice to Lessor,
Lessee  shall  have the right to  terminate  the Lease Term for all but not less
than all of the  Equipment  subject  to this Lease on any  Rental  Payment  Date
designated in such notice (the "Termination  Date") by payment of the Stipulated
Loss Value  determined  in accordance  with  Schedule of Stipulated  Loss Values
attached hereto and made a part hereof. Provided that Lessor shall have received
all amounts  payable  hereunder on the  Termination  Date,  and that no Event of
Default  then exists and is  continuing  under the Lease,  Lessee  shall have no
further  obligation  to make  Rent  payments  hereunder  and  this  Lease  shall
terminate in  accordance  with the  provisions  hereof,  whereupon  Lessor shall
convey all of its right, title and interest in and to the Equipment to lessee as
of the Termination Date, on as "AS-IS," "WHERE-IS" BASIS WITHOUT  REPRESENTATION
OR WARRANTY, EXPRESS OR IMPLIED, and without recourse to Lessor, except that the
Equipment shall be free and clear of all liens created by Lessor.

     8. For the  purposes of the Lease only,  the fourth  sentence of the second
paragraph of Section 9 to the Master Lease is hereby  deleted and replaced  with
the following:

     "In the event Lessor takes  possession and disposes of the  Equipment,  the
     proceeds of any such  disposition  shall be applied in the following order:
     (1) to all of  Lessor's  costs,  charges and  expenses  incurred in taking,
     removing,  holding,  repairing and selling or leasing the Equipment; (2) to
     the extent not  previously  paid by Lessee,  to pay lessor for any  damages
     then remaining unpaid hereunder and to pay any other  Obligations  (defined
     below) then due and owing to lessor;  (3) to reimburse  lessee for any sums
     previously  paid by lessee as damages  hereunder;  and (4) the balance,  if
     any, shall be distributed to lessee."

As used in  this  Lease,  the  term  "Obligations"  means  all  indebtedness  or
liabilities of Lessee under or in respect of one or more leases,  leans,  notes,
credit  agreements,   reimbursement  agreements,   security  agreements,   title
retention or conditional  sales agreements,  or other documents,  instruments or
agreements,  whether now  existing or  hereafter  arising,  evidencing  Lessee's
obligations  for the  payment  of  rents,  borrowed  money  or  other  financial
accommodations owing to Lessor.

Lessor  acknowledges  and agrees that this Lease is  intended to be  capitalized
lease of the  Equipment  and that Lessee  intends to  capitalize  the rental and
other  payment  obligations  of Lessee  hereunder in accordance  with  generally
accepted  accounting  principles and to claim all tax benefits  associated  with
ownership of the Equipment.

Dated as of:  MARCH 26, 1999

FLEET CAPITAL CORPORATION                        INTEGRAMED AMERICA, INC.

By:     /s/John Scott Sibley                     By:      /s/Gerardo Canet
        --------------------                              -----------------
Name:   John Scott Sibley                        Name:    Gerardo Canet
Title:  Vice President                           Title:   President and CEO


<PAGE>


          FLEET                                         ACCEPTANCE CERTIFICATE
Capital Leasing
50 Kennedy Plaza
Providence, Rhode Island 02903-2305


     This Acceptance Certificate (this "Acceptance  Certificate") is attached to
and made a part of that  certain  Lease  Schedule No.  32793-00001,  dated as of
March 26, 1999 (the "Lease Schedule"),  by and between the undersigned  parties.
All capitalized terms used herein and not defined herein shall have the meanings
set forth or  referred  to in the Lease  Schedule.  To the  extent the terms set
forth in this  Acceptance  Certificate  differ or conflict with any of the terms
set forth in the Lease, the terms set forth in this Acceptance Certificate shall
control.

     1. Lessee  acknowledges and agrees that each item of Equipment set forth on
Schedule A hereto  (collectively,  the  "Equipment")  is hereby  unconditionally
accepted by Lessee for all purposes  under the Lease at the locations  specified
in  Schedule  A-1 hereto,  and hereby  agrees to  faithfully  perform all of its
obligations  under  the Lease as of the date  hereof  (the  "Acceptance  Date").
Lessee hereby  authorizes  and directs  Lessor to make payment to each vendor of
the Equipment pursuant to such vendor's invoice or any purchase order,  purchase
agreement or supply contract with such vendor, receipt and approval of which are
hereby reaffirmed by Lessee.

     2. By its execution  and delivery of this  Acceptance  Certificate,  Lessee
hereby reaffirms all of the representations,  warranties and covenants contained
in the Lease as of the date  hereof,  and  further  represents  and  warrants to
Lessor that no Event of Default,  and no event or condition which with notice or
the passage of time or both would  constitute an Event of Default,  has occurred
and is continuing as of the date hereof. Lessee further certifies to Lessor that
Lessee has  selected  the  Equipment  and has received and approved the purchase
order,  purchase  agreement or supply contract under which the Equipment will be
acquired for all purposes of the Lease.

     3. Lessee hereby  represents  and warrants that: (a) the Equipment has been
delivered  and is in an operating  condition  and  performing  the operation for
which it is intended to the satisfaction of the Lessee;  and (b) if requested by
lessor,  the  Equipment  has been  marked or  labeled  evidencing  the  Lessor's
interest therein.

     4. The LEASE TERM COMMENCEMENT DATE is the 1st day of April, 1999.

     5. The RENTAL PAYMENT COMMENCEMENT DATE is the 1st day of April, 1999.

     6. All terms and  provisions  of the Lease  Schedule  shall  remain in full
force and effect, except as otherwise provided below:

        - ACQUISITION COST: $531,723.48

        - LEASE TERM:       forty-eight months

        - RENTAL PAYMENTS:  Number of Rental payments      Rental Payment Amount
                            -------------------------      ---------------------
                                      48                         $12,894.93

        - Advance Rental payment(s): First 01 and last 00.
        - Security Deposit:          N/A%.

Dated:  April 1, 1999

Agreed and Accepted:

FLEET CAPITAL CORPORATION                              INTEGRAMED AMERICA, INC.

By:     /s/J. Scott Sibley                             By:    /s/Gerardo Canet
        ------------------                                    ----------------
Name:   J. Scott Sibley                                Name:  Gerardo Canet
Title:  Vice President                                 Title: President and CEO


<PAGE>


                                   SCHEDULE A
                                    EQUIPMENT

Attached hereto and made part of the following documents:
              Lease Schedule No. 32793-00001,
              Acceptance Certificate and UCC-1 Financing Statement

With:  IntegraMed America, Inc.

  Quantity      Model     Description                              Serial #
  --------      -----     -----------                              --------

                          Location No. 01
                          Vendor No. 01
                          IBM hardware and software
    01                    AIX version 4.3 1-2User  server  license
    78                    XIX version 4.3  additional  user license
    01                    Media processing Charge (CD-ROM)
    01                    MEDIC Integration  (large)
    02                    SSA 4-Port  multi-initiator  controller
    01                    IBM Model H50 PowerPC server
    03                    4.5GB Hot swap disk drive
    01                    Memory  expansion card
    01                    Upgrade 128MB RAM to 256MB RAM Card
    07                    256MB  Ram  card
    01                    Upgrade  Single  332  MHz.  CPU to Dual 332 MHz.  CPU
    01                    Additional  Dual 332 MHz.  CPU
    01                    12/24GB  Internal  4mm Tape Drive
    12                    8mm Tape Cartridge
    01                    SCSI Disk hot swap 6-pack
    01                    S00 Rack unit
    01                    Single phase PDU for rack
    01                    128-Port  async PCI adapter
    02                    10/100 mbps PCI ethernet card
    01                    IBM 3153 terminal
    01                    7133-020 SSA disk subsystem (rack amount)
    08                    4.5GB SSA disk drive
    08                    5.0M SSA copper cable
    01                    8mm cleaning  cartridge
    01                    16-port  async  concentrator for  128-port  adapter
    01                    +MEDIC  Vision/PM   software
    150                   +MEDIC  Vision/PM concurrent  Text User
    01                    MultiTech 28.8 Modem
    01                    MultiTech 28.8 Modem
    01                    A/B/C/D Phone  Switch
    01                    APC  Matrix  5KVA UPS Unit
    150                   Informix  RDBMS,  4GL Per User License
    01                    Informix SGL Single User License
    01                    PowerChute  Plus for AIX Shutdown Software
    02                    Cognos  Impromptu  Administrator  (single user)
    04                    Cognos  PowerPlay Administrator (single user)

                             WITH ALL STANDARD AND ACCESSORY EQUIPMENT

FLEET CAPITAL CORPORATION                           INTEGRAMED AMERICA, INC.

By:     /s/J. Scott Sibley                           By:      /s/Gerardo Canet
        ------------------                                    -----------------
Name:   J. Scott Sibley                              Name:    Gerardo Canet
Title:  Vice President                               Title:   President and CEO


<PAGE>


                                  SCHEDULE A-1
                               EQUIPMENT LOCATION

Attached hereto and made part of the following documents:
                 Lease schedule No. 32793-0001 and
                 Acceptance Certificate

With:   IntegraMed America, Inc.

        Location #           Equipment Location
        ----------           ------------------

        01                   One Manhattanville Road
                             Purchase, NY 10577










































FLEET CAPITAL CORPORATION                      INTEGRAMED AMERICA, INC.

By:     /s/J. Scott Sibley                     By:      /s/Gerardo Canet
        ------------------                              -----------------
Name:   J. Scott Sibley                        Name:    Gerardo Canet
Title:  Vice President                         Title:   President and CEO


<PAGE>


          FLEET                                     PURCHASE OBLIGATION RIDER
Capital Leasing
50 Kennedy Plaza
Providence, Rhode Island 02903-2305

        This Purchase  Obligation Rider (this "Rider") is attached to and made a
part of that certain Lease Schedule No.  32793-0001,  dated as of March 26, 1999
(the "Lease Schedule"), by and between the undersigned parties.

Upon the  expiration  of the Lease Term,  Lessor shall sell to Lessee and Lessee
shall  purchase  from Lessor all, but not less than all, of the Equipment for an
amount,  payable  in  immediately  available  funds on the last day of the Lease
Term, equal to: (a) all Rental Payments,  late charges and other amounts due and
owing under the Lease; plus (b) all taxes,  assessments and other charges due or
payble in connection with the sale of the Equipment to Lessee; plus (c) $1.00.

Upon receipt by Lessor of all amounts payable hereunder, Lessor shall convey all
of its  right,  title  and  interest  in and to the  Equipment  to  Lessee on an
"AS-IS,"  "WHERE-IS"  BASIS,  WITHOUT  REPRESENTATION  OR  WARRANTY,  EXPRESS OR
IMPLIED, and without recourse to Lessor, except that the Equipment shall be free
and clear of all liens created by Lessor.

        All capitalized  terms used herein and not defined herein shall have the
meanings set forth or referred to in the Lease Schedule.  Except as specifically
set forth herein,  all of the terms and  conditions of the Lease shall remain in
full force and effect and are hereby  ratified and affirmed.  To the extent that
the  provisions  of this Rider  conflict  with any  provisions  contained in the
Lease, the provisions of this Rider shall control.

Dated as of:  MARCH 26, 1999


FLEET CAPITAL CORPORATION                          INTEGRAMED AMERICA, INC.

By:     /s/J. Scott Sibley                         By:      /s/Gerardo Canet
        ------------------                                  ----------------
Name:   J. Scott Sibley                            Name:    Gerardo Canet
Title:  Vice President                             Title:   President and CEO



<TABLE> <S> <C>


<ARTICLE>                     5

<MULTIPLIER>                                   1,000


<S>                                            <C>
<PERIOD-TYPE>                                  9-mos
<FISCAL-YEAR-END>                              Dec-31-1999
<PERIOD-START>                                 Jan-01-1999
<PERIOD-END>                                   Sep-30-1999
<CASH>                                         3,882
<SECURITIES>                                   0
<RECEIVABLES>                                  12,196
<ALLOWANCES>                                   731
<INVENTORY>                                    0
<CURRENT-ASSETS>                               16,516
<PP&E>                                         6,388 <F1>
<DEPRECIATION>                                 0
<TOTAL-ASSETS>                                 42,826
<CURRENT-LIABILITIES>                          9,774
<BONDS>                                        0
                          0
                                    166
<COMMON>                                       55
<OTHER-SE>                                     28,322
<TOTAL-LIABILITY-AND-EQUITY>                   42,826
<SALES>                                        33,255
<TOTAL-REVENUES>                               33,255
<CGS>                                          26,032
<TOTAL-COSTS>                                  26,032
<OTHER-EXPENSES>                               5,283
<LOSS-PROVISION>                               0
<INTEREST-EXPENSE>                             294 <F2>
<INCOME-PRETAX>                                1,646
<INCOME-TAX>                                   217
<INCOME-CONTINUING>                            1,429
<DISCONTINUED>                                 0
<EXTRAORDINARY>                                0
<CHANGES>                                      0
<NET-INCOME>                                   1,429
<EPS-BASIC>                                    0.27
<EPS-DILUTED>                                  0.27

<FN>
<F1>
PP&E is net of accumulated depreciation.
<F2>
Interest is net of interest income of 88.
</FN>




</TABLE>


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