Experiences of Couples with Endometriosis-Associated Infertility: A Qualitative Systematic Review

Abstract

Aims: To explore the experiences of couples with endometriosis-associated infertility. Background: Endometriosis is a debilitating chronic gynaecological condition affecting approximately 10% of women worldwide. It is highly associated with infertility and affects many couples in their prime reproductive age. With the increasing burden on infertility worldwide, and the growing value of relational research in the management of chronic illness, it is important to understand the experiences of couples with endometriosis-associated infertility to provide holistic care that addresses both women and partners. Design: Qualitative meta-synthesis using Sandelowski and Barroso’s guidelines. Method: Seven databases (PubMed, Embase, CINAHL, PsycINFO, Scopus, Web of Science and ProQuest Dissertations and Theses) were searched for qualitative studies. Critical appraisal was performed using the Critical Appraisal Skills Programme (CASP) checklist. Qualitative data were extracted, then meta-summarized and meta-synthesized. Results: Thirteen studies were included and fives themes emerged from the synthesis: (1) Innate Response to the Diagnosis, (2) Decision-Making Surrounding Family Planning, (3) The ‘Trying’ to Acceptance Process, (4) Revision of Expected Life Trajectories, and (5) Different Dynamics within the Couple Unit. Conclusions: Couples with endometriosis-associated infertility experience prolonged grief and persisting problems. Long-term management and psychological support should be offered to couples to ensure continuity of care. Endometriosis causes profound impact on relationships and is a shared burden within the couple dyad. Couple-based therapies should include strategies aimed at enhancing emotional support within dyads. Attention should also be paid to men’s emotional wellbeing, and more partner-based research is needed to achieve a broader understanding. Overall, there is no one-size-fits-all approach to care, and contextual information is necessary to provide tailored care to couples struggling with endometriosis- associated infertility.