title: Practice of in-vitro fertilization: a case study from Finland.
abstract: In 1978 the first human IVF-baby was born. Today IVF is a standard procedure in the treatment of infertility in industrialized Western countries. In this study we analyzed how IVF reached an established position as a medical innovation in Finland, how IVF-care was organized between 1991-1993, and which kind of women used IVF-services and delivered a child as a result. The data sources were interviews with practicing IVF-physicians, a survey of Finnish IVF-clinics, telephone interviews with a sample of the adult population, and data of mothers from the Finnish Birth Registry. IVF in Finland followed the four stages of a medical innovation from a promising report into a standard procedure. Key factors in the introduction of IVF-methods were the work of andrologists', and later, IVF-physicians' associations, the approval of the method by head gynecologists in university clinics and among other colleagues, and later, the increase in IVF-services without regulatory government policy. IVF has become increasingly available in private clinics because pioneer physicians have established such services. In principle there was no social discrimination in having IVF, because it was available almost free of charge in public clinics. But the costs and availability of private clinics created unequal access to IVF services. IVF-women were more often upper-class white collar employees living in southern Finland than women in the control group. IVF has been a routine treatment option of infertility since the end of the 1980s. It has provided a medical technology solution to infertility. The supply and demand of IVF has increased and its indications have widened in the treatment of infertility. This is the inner logic of a successful technology: after the developmental processes of a revolutionary innovation, the use of technology escalates rapidly and the barriers for its use decrease.
authors.affiliation: National Research and Development Centre for Welfare and Health, Helsinki, Finland.
authors.forename: M M
authors.initials: MM
authors.lastname: Silverio
authors.forename: E
authors.initials: E
authors.lastname: Hemminki
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007246:Infertility / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D008297:Male; D011247:Pregnancy