A Qualitative Evidence Synthesis of Women’s Experience of Infertility and Fertility Treatment From an Existential Perspective

Abstract

While infertility and fertility treatment cause significant psychological distress for many women, the effectiveness of existing psychological interventions is unproven. This paper explores the potential applicability of an existential psychotherapeutic framework in this context by reviewing the lived experience of women with infertility and women in fertility treatment from an existential perspective. We conducted a qualitative evidence synthesis, specifically a best fit framework synthesis. Qualitative studies that included quotations from women with infertility and women in fertility treatment addressing one or more existential concerns were reviewed. Irvin Yalom’s existential framework provided a pre-existing framework into which the findings from the studies were extracted and synthesized, producing a revised model. Of 1,506 studies screened, 144 satisfied inclusion criteria. Sixteen themes were populated deductively by quotations from the studies. Quotations not coded into the a priori themes were synthesized inductively to develop 13 additional themes, resulting in an Existential Model of Women in Fertility Treatment. Based on this model, the psychological challenges and opportunities for growth associated with infertility and fertility treatment can be understood as relating to: (1) loss and grief, and the threatened loss of symbolic immortality, (2) the powerlessness to direct one’s life, (3) alienation from the fertile world and diminished sense of self, and (4) the threatened loss of meaning and purpose. This review generated an Existential Model of Women in Fertility Treatment. Future research is needed to test the validity of this model, including research aimed at developing and testing existentially oriented interventions for this population.