Accounting for complexity in healthcare innovation debates: Professional views on the use of new IVF treatments


Social scientists have long been interested in the forces and values driving healthcare innovation. The simultaneous rise of 20th century healthcare reforms, increased importance of evidence and upsurge in lay health activism have shaped modern medicine. On this backdrop, fertility care emerged in the 1970s. Recent developments reveal a contentious relationship between new fertility treatments and clinical evidence, with emerging technologies being used without conclusive evidence of effectiveness despite being sold to patients. Initial critiques of this phenomenon emphasise commercial interests as the culprit, suggesting that the problematic use of unproven treatments is mainly driven by the private sector. Here, we challenge this over-simplified view of IVF care. Drawing on a qualitative analysis of key documents and 43 in-depth professional interviews, this article identifies three main stakeholder approaches to new treatment adoption. We argue that viewpoints are anchored within three critical overarching ‘modes of coordination’ or core values in modern healthcare: efficiency, effectiveness and patient-centeredness. This analysis encourages a more contextualised overview of fertility care than previous literatures have afforded. The IVF case shows that an emphasis on private versus public clinic practices obscure similarities between the two along with the values motivating healthcare professionals’ approaches to new treatments.

Publication DOI:
Divisions: College of Business and Social Sciences > School of Social Sciences & Humanities > Sociology and Policy
College of Business and Social Sciences > School of Social Sciences & Humanities
Additional Information: This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( Funding: Wellcome Trust 108577/Z/15/Z
Publication ISSN: 1363-4593
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Related URLs: https://journal ... 634593221074874 (Publisher URL)
PURE Output Type: Article
Published Date: 2022-02-01
Published Online Date: 2022-02-01
Accepted Date: 2022-01-03
Authors: Geampana, Alina (ORCID Profile 0000-0001-7388-7181)
Perrotta, Manuela



Version: Published Version

License: Creative Commons Attribution

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