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Experiences of endometriosis-associated infertility among women and their partners: A qualitative systematic review.

AIMS AND OBJECTIVES
To consolidate and synthesise the current available literature regarding the experiences of endometriosis-associated infertility among women and their partners.


BACKGROUND
Endometriosis is highly associated with infertility which in turn affects many women and their partners in their prime reproductive age.


DESIGN
A qualitative systematic review and meta-synthesis was conducted using the PRISMA checklist.


METHODS
Seven electronic databases (PubMed, Embase, CINAHL, PsycINFO, Scopus, Web of Science and ProQuest Dissertations and Theses) were searched until October 2020. Qualitative studies exploring the experiences of women and/or their partners aged 18 years and above with endometriosis-associated infertility regardless of marital or co-inhabitation status and sexual orientation were included. Studies examining women and/or partners without clinical diagnosis of endometriosis and studies which only focused on the psychosocial experiences of endometriosis were excluded. The Critical Appraisal Skills Program checklist was used to conduct quality appraisal while the Sandelowski and Barroso's two-step approach was used to meta-summarise and meta-synthesise the data from the included studies.


RESULTS
Thirteen studies were included. Five themes (1) Emotional response to the diagnosis, (2) Influence on family planning, (3) Desperation to gradual acceptance, (4) Revision of expected life trajectories and (5) Altered dynamics within the couple unit were derived.


CONCLUSION
Endometriosis causes great psychological distress among women and their partners. Family planning decisions were especially challenging to make for the couples. Unsuccessful attempts at conceiving were extremely distressing but some couples eventually accepted their situation, with some opting for hysterectomy for health reasons.


RELEVANCE TO CLINICAL PRACTICE
Current findings highlight the need for psychosocial support, in-depth fertility counselling and couple-based therapies to support the women with endometriosis and their partners.