A Qualitative Evidence Synthesis of Women’s Experience of Infertility and Fertility Treatment From an Existential Perspective
Bibliographic record
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.050 | 0.071 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.008 | 0.012 |
| Science and technology studies | 0.004 | 0.006 |
| Scholarly communication | 0.005 | 0.007 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".