THIS  WARRANT AND THE SHARES OF COMMON STOCK INTO WHICH IT IS  EXERCISABLE  HAVE
NOT BEEN  REGISTERED  UNDER THE SECURITIES ACT OF 1933 (THE "ACT") NOR UNDER ANY
STATE  SECURITIES  LAW AND MAY  NOT BE  PLEDGED,  SOLD,  ASSIGNED  OR  OTHERWISE
TRANSFERRED UNTIL A (1) REGISTRATION  STATEMENT UNDER THE ACT AND ANY APPLICABLE
STATE SECURITIES LAW HAS BECOME  EFFECTIVE WITH RESPECT THERETO,  OR (2) RECEIPT
BY THE  COMPANY  OF AN OPINION  OF  COUNSEL  TO THE  COMPANY TO THE EFFECT  THAT
REGISTRATION UNDER THE ACT OR APPLICABLE STATE SECURITIES LAW IS NOT REQUIRED IN
CONNECTION WITH THE PROPOSED TRANSFER.


Warrant Number INMD 1003



            VOID AFTER 5:00 P.M. NEW YORK TIME, ON NOVEMBER 17, 2003
                WARRANT TO PURCHASE 15,625 SHARES OF COMMON STOCK




                        WARRANT TO PURCHASE COMMON STOCK

                                       OF

                            INTEGRAMED AMERICA, INC.




                  This is to Certify That, FOR VALUE RECEIVED,  PATRICIA MCSHANE
("Holder"), is entitled to purchase,  subject to the provisions of this Warrant,
from IntegraMed America, Inc., a Delaware corporation ("Company"),  an aggregate
of 15,625 fully paid,  validly issued and nonassessable  shares of Common Stock,
par value $.01 per share,  of the Company  ("Common  Stock") at a price of $4.12
per share  ("Exercise  Price") from time to time during the period from November
18, 1998 to November 17, 2003,  but not later than 5:00 p.m. New York City Time,
on November 17, 2003 in  accordance  with the terms and  conditions  hereof.  In
addition to any other  adjustments to which the Exercise Price may be subject as
provided for herein,  the Exercise Price shall be subject to a yearly adjustment
of 20% on November 18 of each year of this Warrant, which when so adjusted shall
become  the  adjusted  exercise  price  ("Adjusted   Exercise  Price")  for  the
applicable  12-month period. The number of shares of Common Stock to be received
upon the  exercise  of this  Warrant  and the price to be paid for each share of
Common Stock may be adjusted  from time to time as  hereinafter  set forth.  The
shares of Common Stock deliverable upon such exercise, and as adjusted from time


                                        1




to time,  are  hereinafter  sometimes  referred to as  "Warrant  Shares" and the
exercise  price of a share of Common Stock in effect at any time and as adjusted
from time to time is hereinafter  sometimes  referred to as the "Exercise Price"
or "Adjusted Exercise Price".

                  (a)      EXERCISE OF WARRANT.

                           (1) This Warrant may be  exercised  from time to time
on or after  November  18,  1998 and until  November  17,  2003,  subject to the
provisions of Sections (a)(2) through (a) (8) hereof; provided, however, that if
such day is a day on which  banking  institutions  in the  State of New York are
authorized by law to close,  then on the next  succeeding day which shall not be
such a day. This Warrant may be exercised by  presentation  and surrender to the
Company at its principal office,  the Purchase Form annexed hereto duly executed
and  accompanied  by  payment  of the  Exercise  Price for the number of Warrant
Shares  specified in such form. As soon as practicable  after each such exercise
of the warrants, the Company shall cause its transfer agent to issue and deliver
to the Holder a certificate or certificate  for the Warrant Shares issuable upon
such  exercise,  registered  in the name of the  Holder  or its  designee.  Upon
receipt by the  Company of the  Purchase  Form at its office in proper  form for
exercise, the Holder shall be deemed to be the holder of record of the shares of
Common  Stock  issuable  upon  such  exercise,  notwithstanding  that the  stock
transfer  books  of the  Company  shall  then be  closed  or  that  certificates
representing such shares of Common Stock shall not then be physically  delivered
to the Holder.

                           (2) Holder may  acquire up to 3,125  shares of Common
Stock at the  Exercise  Price  between  November  18, 1998 and November 17, 1999
("First Exercise Period").

                           (3) Holder may  acquire up to 3,125  shares of Common
Stock at the 1999 Adjusted Exercise Price between November 18, 1999 and November
17, 2000 ("Second Exercise Period").

                           (4) Holder may  acquire up to 3,125  shares of Common
Stock at the 2000 Adjusted Exercise Price between November 18, 2000 and November
17, 2001 ("Third Exercise Period").

                           (5) Holder may  acquire up to 3,125  shares of Common
Stock at the 2001 Adjusted Exercise Price between November 18, 2001 and November
17, 2002 ("Fourth Exercise Period").

                           (6) Holder may  acquire up to 3,125  shares of Common
Stock at the 2002 Adjusted Exercise Price between November 18, 2002 and November
17, 2003 ("Fifth Exercise Period").


                                        2





                           (7) Holder must be an employee, in good-standing,  of
REPRODUCTIVE  SCIENCE CENTER(R) of Boston ("PC") at the time Holder acquires any
of the shares provided for iN this Warrant.

                           (8) In the event the Management Agreement, as amended
from time to time,  dated as of  October  1, 1997  between  the  Company  and PC
terminates,  this  Warrant  shall  terminate  effective on the same date and any
rights to acquire  Common  Stock of the  Company not  exercised  as of that date
shall cease, be null and void and of no effect.

                  (b)  RESERVATION  OF SHARES.  The  Company  shall at all times
reserve for issuance  and/or  delivery upon exercise of this Warrant such number
of shares of its Common  Stock as shall be required  for  issuance  and delivery
upon exercise of the Warrants.

                  (c)  FRACTIONAL   SHARES.   No  fractional  shares  or  script
representing  fractional  shares  shall  be  issued  upon the  exercise  of this
Warrant.  With  respect to any  fraction of a share called for upon any exercise
hereof,  the  Company  shall pay to the  Holder an amount in cash  equal to such
fraction  multiplied  by the  current  market  value of a share,  determined  as
follows:

                           (1) If the  Common  Stock  is  listed  on a  national
                  securities exchange or admitted to unlisted trading privileges
                  on such exchange or listed for trading on the Nasdaq  National
                  Market,  the current  market value shall be the last  reported
                  sale price of the Common  Stock on such  exchange or market on
                  the last  business  day prior to the date of  exercise of this
                  Warrant  or if no such sale is made on such day,  the  average
                  closing bid and asked prices for such day on such  exchange or
                  market; or

                           (2) If the Common  Stock is not so listed or admitted
                  to unlisted  trading  privileges,  but is traded on the Nasdaq
                  Small  Cap  Market,  the  current  Market  Value  shall be the
                  average of the  closing  bid and asked  prices for such day on
                  such  market  and if the Common  Stock is not so  traded,  the
                  current  market  value shall be the mean of the last  reported
                  bid  and  asked  prices  reported  by the  National  Quotation
                  Bureau, Inc. on the last business day prior to the date of the
                  exercise of this Warrant; or

                           (3) If the Common  Stock is not so listed or admitted
                  to unlisted  trading  privileges  and bid and asked prices are
                  not so reported,  the current market value shall be an amount,
                  not less than  book  value  thereof  as at the end of the most
                  recent fiscal year of the Company  ending prior to the date of
                  the exercise of the  Warrant,  determined  in such  reasonable
                  manner as may be  prescribed  by the Board of Directors of the
                  Company.

                  (d) EXCHANGE,  TRANSFER,  ASSIGNMENT OR LOSS OF WARRANT.  This
Warrant is  exchangeable,  without  expense,  at the option of the Holder,  upon
presentation  and surrender  hereof to the Company or at the office of its stock
transfer agent, if any, for other warrants of different  denominations entitling


                                        3





the holder  thereof to  purchase in the  aggregate  the same number of shares of
Common  Stock  purchasable  hereunder.  This  Warrant  is  not  transferable  or
assignable  (other  than  by  will  or  pursuant  to the  laws  of  descent  and
distribution). This Warrant may be divided or combined with other warrants which
carry the same rights upon  presentation  hereof at the principal  office of the
Company or at the office of its stock transfer  agent,  if any,  together with a
written notice  specifying the names and denominations in which new Warrants are
to be issued and signed by the Holder hereof.  The term "Warrant" as used herein
includes any Warrants into which this Warrant may be divided or exchanged.  Upon
receipt  by the  Company  of  evidence  satisfactory  to it of the loss,  theft,
destruction  or mutilation of this Warrant,  and (in the case of loss,  theft or
destruction) of reasonably satisfactory indemnification,  and upon surrender and
cancellation of this Warrant, if mutilated, the Company will execute and deliver
a new  Warrant  of like  tenor  and  date.  Any such new  Warrant  executed  and
delivered shall constitute an additional  contractual  obligation on the part of
the  Company,  whether  or not this  Warrant  so  lost,  stolen,  destroyed,  or
mutilated shall be at any time enforceable by anyone.

                  (e)  RIGHTS OF THE  HOLDER.  The Holder  shall not,  by virtue
hereof, be entitled to any rights of a shareholder in the Company, either at law
or equity,  and the rights of the Holder are limited to those  expressed  in the
Warrant and are not  enforceable  against  the Company  except to the extent set
forth herein.

                  (f) ANTI-DILUTION PROVISIONS.  The Exercise Price in effect at
any time and the number and kind of securities  purchasable upon the exercise of
the Warrants shall be subject to adjustment from time to time upon the happening
of certain events as follows:

                           (1) In case the Company  shall (i) declare a dividend
                  or make a  distribution  on its  outstanding  shares of Common
                  Stock in shares of Common Stock,  (ii) subdivide or reclassify
                  its  outstanding  shares of Common Stock into a greater number
                  of shares,  or (iii)  combine or  reclassify  its  outstanding
                  shares of Common  Stock into a smaller  number of shares,  the
                  Exercise  Price in effect at the time of the  record  date for
                  such dividend or distribution or of the effective date of such
                  subdivision, combination or reclassification shall be adjusted
                  so that it shall equal the price determined by multiplying the
                  Exercise Price by a fraction,  the  denominator of which shall
                  be the  number of shares of  Common  Stock  outstanding  after
                  giving effect to such action, and the numerator of which shall
                  be  the   number  of  shares  of  Common   Stock   outstanding
                  immediately  prior to such action.  Such  adjustment  shall be
                  made successively whenever any event listed above shall occur.

                           (2) Whenever the Exercise Price payable upon exercise
                  of each Warrant is adjusted  pursuant to Subsection (1) above,
                  the number of Shares purchasable upon exercise of this Warrant
                  shall  simultaneously be adjusted by multiplying the number of
                  Shares initially issuable upon exercise of this Warrant by the
                  Exercise  Price in effect on the date hereof and  dividing the
                  product so obtained by the Exercise Price, as adjusted.


                                        4





                           (3) No  adjustment  in the  Exercise  Price  shall be
                  required unless such  adjustment  would require an increase or
                  decrease  of at  least  five  cents  ($0.05)  in  such  price;
                  provided,  however,  that any  adjustments  which by reason of
                  this  Subsection  (3) are not  required  to be made  shall  be
                  carried  forward  and taken  into  account  in any  subsequent
                  adjustment  required to be made  hereunder.  All  calculations
                  under this Section (f) shall be made to the nearest cent or to
                  the  nearest  one-hundredth  of a  share,  as the case may be.
                  Anything in this Section (f) to the contrary  notwithstanding,
                  the Company shall be entitled,  but shall not be required,  to
                  make such changes in the Exercise  Price, in addition to those
                  required by this  Section (f), as it shall  determine,  in its
                  sole discretion, to be advisable in order that any dividend or
                  distribution  in shares of Common Stock,  or any  subdivision,
                  reclassification  or  combination  of Common Stock,  hereafter
                  made by the Company shall not result in any Federal Income tax
                  liability  to  the  holders  of  Common  Stock  or  securities
                  convertible into Common Stock (including Warrants).

                           (4)  Whenever  the  Exercise  Price is  adjusted,  as
                  herein provided,  the Company shall promptly but no later than
                  10 days  after  any  request  for  such an  adjustment  by the
                  Holder,  cause a notice  setting  forth the adjusted  Exercise
                  Price and adjusted  number of Shares issuable upon exercise of
                  each Warrant,  and, if requested,  information  describing the
                  transactions giving rise to such adjustments,  to be mailed to
                  the Holders at their last  addresses  appearing in the Warrant
                  Register,  and shall  cause a  certified  copy  thereof  to be
                  mailed to its transfer agent, if any. The Company may retain a
                  firm of independent  certified public accountants  selected by
                  the Board of  Directors  (who may be the  regular  accountants
                  employed by the Company) to make any  computation  required by
                  this Section (f), and a certificate  signed by such firm shall
                  be conclusive evidence of the correctness of such adjustment.

                           (5) In the event that at any time,  as a result of an
                  adjustment  made pursuant to Subsection (1) above,  the Holder
                  of this Warrant  thereafter  shall become  entitled to receive
                  any shares of the Company, other than Common Stock, thereafter
                  the number of such other shares so receivable upon exercise of
                  this Warrant shall be subject to adjustment  from time to time
                  in a manner and on terms as nearly  equivalent as  practicable
                  to the provisions  with respect to the Common Stock  contained
                  in Subsections (1) to (3), inclusive above.

                  (g) OFFICER'S  CERTIFICATE.  Whenever the Exercise Price shall
be adjusted as required by the provisions of the foregoing Section,  the Company
shall  forthwith file in the custody of its Secretary or an Assistant  Secretary
at its principal  office and with its stock transfer agent, if any, an officer's
certificate  showing the adjusted  Exercise Price determined as herein provided,
setting  forth  in  reasonable  detail  the  facts  requiring  such  adjustment,
including a statement of the number of  additional  shares of Common  Stock,  if
any,  and such other facts as shall be  necessary to show the reason for and the
manner of computing such adjustment.  Each such officer's  certificate  shall be
made  available  at all  reasonable  times for  inspection  by the holder or any
holder of a Warrant  executed  and  delivered  pursuant  to Section  (a) and the


                                        5




Company shall,  forthwith after each such  adjustment,  mail a copy by certified
mail of such certificate to the Holder or any such holder.

                  (h) NOTICES TO WARRANT HOLDERS.  So long as this Warrant shall
be  outstanding,  (i)  if the  Company  shall  pay  any  dividend  or  make  any
distribution  upon the Common  Stock or (ii) if the  Company  shall offer to the
holders of Common  Stock for  subscription  or purchase by them any share of any
class or any other rights or (iii) if any capital reorganization of the Company,
reclassification of the capital stock of the Company, consolidation or merger of
the Company with or into another corporation,  sale, lease or transfer of all or
substantially  all  of  the  property  and  assets  of the  Company  to  another
corporation, or voluntary or involuntary dissolution,  liquidation or winding up
of the Company shall be effected, then in any such case, the Company shall cause
to be mailed by certified  mail to the Holder,  at least  fifteen days prior the
date  specified in (x) or (y) below,  as the case may be, a notice  containing a
brief  description  of the  proposed  action and stating the date on which (x) a
record is to be taken for the purpose of such dividend,  distribution or rights,
or (y) such reclassification, reorganization, consolidation, merger, conveyance,
lease, dissolution,  liquidation or winding up is to take place and the date, if
any is to be fixed, as of which the holders of Common Stock or other  securities
shall receive cash or other  property  deliverable  upon such  reclassification,
reorganization,  consolidation,  merger, conveyance, dissolution, liquidation or
winding up.

                  (i) RECLASSIFICATION, REORGANIZATION OR MERGER. In case of any
reclassification,  capital  reorganization or other change of outstanding shares
of Common Stock of the Company, or in case of any consolidation or merger of the
Company with or into another  corporation (other than a merger with a subsidiary
in which  merger the Company is the  continuing  corporation  and which does not
result  in any  reclassification,  capital  reorganization  or other  change  of
outstanding  shares of Common Stock of the class  issuable upon exercise of this
Warrant) or in case of any sale,  lease or conveyance to another  corporation of
the property of the Company as an entirety,  the Company  shall,  as a condition
precedent to such transaction, cause effective provisions to be made so that the
Holder shall have the right  thereafter by  exercising  this Warrant at any time
prior to the  expiration  of the  Warrant,  to  purchase  the kind and amount of
shares  of  stock  and  other  securities  and  property  receivable  upon  such
reclassification,   capital  reorganization  and  other  change,  consolidation,
merger,  sale or  conveyance by a holder of the number of shares of Common Stock
which might have been purchased upon exercise of this Warrant  immediately prior
to such reclassification, change, consolidation, merger, sale or conveyance. Any
such provision shall include  provision for adjustments which shall be as nearly
equivalent  as may  be  practicable  to the  adjustments  provided  for in  this
Warrant.  The foregoing  provisions of this Section (i) shall similarly apply to
successive  reclassifications,  capital reorganizations and changes of shares of
Common Stock and to successive consolidations, mergers, sales or conveyances. In
the  event  that  in  connection  with  any  such  capital   reorganization   or
reclassification,  consolidation,  merger, sale or conveyance, additional shares
of Common  Stock  shall be  issued  in  exchange,  conversion,  substitution  or
payment,  in whole or in part,  for a security of the Company  other than Common
Stock,  any such issue shall be treated as an issue of Common  Stock  covered by
the provisions of Subsection (1) of Section (f) hereof.

                                        6





                            INTEGRAMED AMERICA, INC.



                                            By   /s/Gerardo Canet
                                                 ------------------------------
                                                 Gerardo Canet, President & CEO
Date: November 18, 1998


Attest:

/s/Claude E. White
- -----------------------------
Claude E. White, Secretary


[Seal]


































                                  PURCHASE FORM


                                                 Date: ________________________


                  The  undersigned  hereby  irrevocably  elects to exercise  the
Warrant dated  ___________________________to  the extent of  purchasing  _______
shares of Common  Stock and  hereby  makes  payment of _______ in payment of the
actual exercise price thereof.


- --------------------------------------------
Signature





                     INSTRUCTIONS FOR REGISTRATION OF STOCK



Name ________________________________
(Please typewrite or print in block letters)


Address ______________________________


Signature _____________________________













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                             STOCK PURCHASE WARRANT




                           To Purchase Common Stock of




                            INTEGRAMED AMERICA, INC.

















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