AMENDMENT NO. 7 TO MANAGEMENT AGREEMENT

                                     BETWEEN

                            INTEGRAMED AMERICA, INC.

                                       AND

                       FERTILITY CENTERS OF ILLINOIS, S.C.




         THIS AMENDMENT NO. 7  TO MANAGEMENT AGREEMENT ("Amendment No. 7")
is dated as of April 1, 2000 by and between IntegraMed America, Inc., a Delaware
corporation,  with its principal place of business at One  Manhattanville  Road,
Purchase,  New York 10577 ("INMD") and Fertility  Centers of Illinois,  S.C., an
Illinois medical corporation, with its principal place of business at 3000 North
Halsted Street, Suite 509, Chicago, Illinois 69657 ("FCI").



                                    RECITALS:

         INMD and FCI entered into a  management  agreement  dated  February 28,
1997,  as amended,  with an effective  date of August 19, 1997 (the  "Management
Agreement");

         INMD and FCI  desire  to amend  further  certain  financial  terms  and
conditions of the Management Agreement governing their relationship.

         NOW THEREFORE,  in  consideration  of the mutual promises and covenants
herein  contained,  and as contained in the Management  Agreement,  INMD and FCI
agree as follows:


         1.       Section   2.1.2  is  hereby   deleted  and  the  following  is
substituted therefor, effective January 1, 2000:

                  "2.1.2 Expenses incurred in recruiting  additional  physicians
                  for FCI, including, but not limited to employment agency fees,
                  travel expenses and relocation  costs; and, up to $175,000 for
                  the  first 12  months of each new  physician's  employment  to
                  cover  such  costs as a signing  bonus,  if any,  and  salary;
                  provided,  however,  any such  amount  must be approved by the
                  Joint Practice  Management Board on a case-by-case basis prior
                  to  being  incurred;   and  provided,   further,   "additional
                  physician"  shall mean a new physician  whose hiring is not to
                  replace a physician  who has left P.C.  within 12 months prior
                  to the  employment  of the new  physician,  but  whose  hiring
                  increases PC's full-time  equivalent  ("FTE")  physicians to a
                  number  greater than PC's FTE  physicians  for the previous 12
                  months;"


<PAGE>




         2.       Section 6.1.4 of the Management Agreement is hereby deleted in
its entirety and the following is hereby substituted therefor, effective January
1, 2000:

                  "6.1.4  during  each  year of this  Agreement,  an  Additional
                  Management  Fee,  paid monthly but  reconciled  quarterly,  in
                  accordance with the following  table; and provided further the
                  Additional  Management  Fee  shall  not  exceed  20% of  FCI's
                  Physician  and Other  Revenues  less Cost of Services  and the
                  Base Management Fee for any Fiscal Year:

                  Cost of Services plus the Base
                  Management Fee as a % of Revenues    Additional Management Fee
                  ---------------------------------    -------------------------

                        50% and Below                    10 1/2% of Revenues
                        51% to 60%                        9 1/2% of Revenues
                        61% to or more                    8 1/2% of Revenues

         3.       All other provisions of the Management Agreement,  as amended,
not in conflict with this Amendment No. 7 remain in full force and effect.

         4.       This  Amendment No.7 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.

         IN WITNESS  WHEREOF,  the parties have signed this  Amendment No. 7 the
date first above written.

INTEGRAMED AMERICA, INC.



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



FERTILITY CENTERS OF ILLINOIS, S.C.



By:/s/Aaron S. Lifchez
   ----------------------------
   Aaron S. Lifchez, President