• Africa
• infertility
• stigma
• systematic review

• Humans
• Female
• Pregnancy
• Ethiopia
• Adult
• Male
• Fertility
• Emotions
• Longitudinal Studies
• Intention
• Pregnant People/psychology
• Cross-Sectional Studies
• Fathers/psychology
• Young Adult
• Spouses/psychology
• Adolescent
• Surveys and Questionnaires
• Secondary Data Analysis

• LMICs
• accessible
• affordable
• assisted reproduction
• infertility care
• low- and middle-income countries
• simplified IVF

• African diaspora
• Poland
• cultural stigma
• infertility
• reproductive health

• Assisted reproductive technology
• Domestic violence
• Infertility
• Intimate partner violence
• Qualitative

• Humans
• Female
• Intimate Partner Violence/psychology
• Adult
• Reproductive Techniques, Assisted/psychology
• Infertility/psychology
• Infertility/therapy
• China/epidemiology
• Qualitative Research
• Infertility, Female/psychology
• Infertility, Female/therapy
• Middle Aged

• 2022YFC2705305 National Key Research and Development Program of China
• 23&ZD184 the National Social Science Foundation of China
• 82204052 the National Natural Science Foundation of China

• Africa
• Infertility
• Psychosocial
• Review
• Scoping review

• Humans
• Infertility/psychology
• Africa
• Social Stigma
• Quality of Life/psychology
• Female
• Male

• care-seeking
• cross-sectional
• infertility
• population-based
• sub-Saharan Africa
• survey

• Humans
• Female
• Africa South of the Sahara
• Patient Acceptance of Health Care/statistics & numerical data
• Adult
• Pregnancy
• Cross-Sectional Studies
• Adolescent
• Young Adult
• Middle Aged

• K01 HD107172 NICHD NIH HHS
• L60 HD113077 NICHD NIH HHS
• INV009639 Bill & Melinda Gates Foundation
• K01HD107172 National Institute of Child Health and Human Development
• Bill & Melinda Gates Foundation

• medically assisted reproduction
• partnership histories
• sequence analysis
• subfertility

• Humans
• Female
• Finland
• Reproductive Techniques, Assisted/statistics & numerical data
• Adult
• Adolescent
• Young Adult
• Longitudinal Studies
• Sexual Partners
• Registries

• Contraception
• Couples
• Qualitative research
• Reproductive coercion
• Reproductive health
• Sub-Saharan Africa

• Couples
• fertility quality of life
• primary infertility
• psychometric
• quality of life

• infertility
• psychometric evaluation
• social comparison
• social rank
• submissive behavior

• Malawi
• Men
• chance of conception
• fertility
• infertility
• perceived infertility

• Humans
• Male
• Malawi
• Adult
• Infertility, Male/psychology
• Fertilization
• Middle Aged
• Young Adult
• Cohort Studies
• Infertility/psychology
• Female

• P2C HD041022 NICHD NIH HHS
• P2C HD058484 NICHD NIH HHS
• R24 HD041022 NICHD NIH HHS
• T32 HD007545 NICHD NIH HHS

• infertility
• mental health
• quality of life
• review
• stigma

• National Natural Science Foundation of China
• Natural Science Research of Jiangsu Higher Education Institutions of China

• Infertility
• Iran
• Quality of life
• Women

• Involuntary Childlessness, Women
• s experiences

Infertility is a long-standing reproductive health issue, which affects both men and women worldwide and it is especially problematic in the Global South. In sub-Saharan Africa, understanding the current availability of diagnostic and treatment services for infertility is important because this could guide health systems to improve access to fertility care for all. Yet, few studies have explicitly started from a health system perspective to grasp the availability and integration of infertility services in sub-Saharan Africa. This quantitative study, the first in The Gambia, West Africa, examines the availability of infertility services in public and private facilities as part of a wider endeavour to improve fertility care policy and practice in the country.

A cross-sectional survey using Qualtrics was administered to 38 health facilities. The survey was carried out between March and August 2021 and involved closed-ended questions. Data analysis consisted of descriptive statistics and t-tests performed using SPSS version 26.

A total of 25 facilities (66%) offered infertility services, of which 13 (52%) were public and 12 (47%) private. Although the availability of screening tests was similar between health institutions, most diagnostic and treatment services were available only in the private sector. Treatment services included: (i) ovarian stimulation (n = 16, 42%); (ii) reversal of tubal ligation and/or blockage (tuboplasty) (n = 4, 11%); and (iii) intrauterine insemination (n = 3, 8%). Assisted reproductive technologies such as IVF and ICSI were not available in public or private sectors. The Gambian health management information system lacked a dedicated space to capture data on infertility. Reported barriers to integration of infertility services in existing reproductive health services included a lack of specialised training, an absence of national guidance on infertility management, and a shortage of appropriate equipment, supplies, and medication.

The availability of infertility services in The Gambia follows a trajectory that is similar to other SSA countries in which services are mostly obtainable through the private sector. Yet, access to private care is expensive and geographically restricted, which exacerbates inequalities in accessing fertility care for all. Improving the provision of infertility services in the public sector requires systematically capturing data on infertility and investing in the provision of a full-range fertility care package.

The online version contains supplementary material available at 10.1186/s12913-022-08514-0.

• ART
• Fertility care
• Infertility services
• Private care
• Sub-Saharan Africa
• The Gambia

The infertility treatment process is associated with various psychological, physical, social, moral, and financial challenges, especially for women. The women are likely to report low marital satisfaction and emotional distress due to fertility treatment demands. This study explored how infertile women described their treatment experience and how they coped with treatment demands as they underwent treatment at three gynecology outpatient clinics in Kenya.

A qualitative phenomenological research design was used to analyze and describe women’s fertility treatment experiences. The data were collected through semi-structured in-depth interviews with 33 infertile women selected purposively. Trustworthiness of the findings was ensured using Guba and Lincoln’s criteria. The recorded interviews were transcribed verbatim and then analyzed using reflective thematic analysis, developed by Braun and Clarkes.

Three themes and 13 sub-themes related to women’s fertility treatment experiences and coping strategies were identified. The theme challenges encountered during fertility treatment have three sub-themes: emotional distressing, physical pain, and financial constraining. Theme impacts of fertility treatment on relationships have three sub-themes: relationship with their husband, relationship with their family, and relationship with their friends. Finally, coping with fertility treatment has six sub-themes: religious practices and personal faith, giving in to feelings, shifting focus, taking a break, staying with their relative’s children, and receiving support from others.

The experiences of women undergoing treatment are multi-dimensional. Therefore, incorporating psychosocial interventions or counseling into the fertility treatment routine with National Health Insurance Fund cards may reduce the treatment burden, improving women’s psychological well-being and relationships with their husbands, family, and friends.

• infertility
• nursing
• resilience
• validation studies

Treatment tolerability and treatment environment are two major spheres of infertility care that may associate with women’s emotional health and coping mechanisms.

The present study aimed at assessing the relationship between infertility treatment quality and various aspects of emotion-focus coping, problem-focus coping, and avoidance coping mechanisms.

The study was completed by using standardized tools and data from this descriptive, cross-sectional, correlational study were collected from 350 women undergoing infertility treatments in private reproductive healthcare centers in Quetta, Pakistan.

Treatment tolerability was found to be positively associated with positive reframing (p < 0.02) and negatively associated with the use of emotional support (p < 0.03); acceptance (p < 0.01); humor (p < 0.03); behavioral disengagement (p < 0.01) and venting (p < 0.01). The quality of the treatment environment demonstrated a negative correlation between religious coping (p < 0.02) and behavioral disengagement (p < 0.01), whereas it showed a positive correlation with active coping (p < 0.03) and planning (p < 0.02). The linear regression analysis demonstrated that treatment tolerability significantly increased with positive reframing (R2 = 0.118, F(304) = 2.22, p < 0.03). Behavioral disengagement significantly decreased with better treatment environment (R2 = 0.111, F(304) = 2.09, p < 0.02).

We discussed the findings keeping in view the role of social, cultural, and economic factors related to infertility care in the context South-Asian culture, and recommendations are made to promote women’s mental health and coping by improving some specific aspects of infertility treatment quality.

High treatment tolerability may associate with some useful aspects of emotion-focus coping, such as positive reframing, whereas low treatment tolerability may associate with avoidance coping, such as behavioral disengagement and venting. Besides, the quality of the infertility treatment environment enables women to use problem-focus coping mechanisms, such as planning and active coping.

• Scientific Research Deanship at the University of Ha’il, Saudi Arabia

• antinatalism
• barrenness
• child-free
• childlessness
• infertile
• sterile

• Humans
• Family Relations
• Infertility/psychology
• Reproductive Behavior

Infertility stigma is a phenomenon associated with various psychological and social tensions especially for women. The stigma is associated with a feeling of shame and secrecy. The present study was aimed to explore the concept of infertility stigma based on the experiences and perceptions of infertile women.

This qualitative conventional content analysis study was conducted in Isfahan Fertility and Infertility Center, Iran. Data were collected through in-depth interviews with 17 women who had primary infertility. All the interviews were recorded, transcribed and analyzed according to the steps suggested by Graneheim and Lundman. The Standards for Reporting Qualitative Research (SRQR) checklist was followed for this research.

Eight hundred thirty-six initial codes were extracted from the interviews and divided into 25 sub-categories, 10 categories, and four themes. The themes included “stigma profile, self-stigma, defensive mechanism and balancing”. Stigma profile was perceived in the form of verbal, social and same sex stigma. Self-stigma was experienced as negative feelings and devaluation. Defensive mechanism was formed from three categories of escaping from the stigma, acceptance and infertility behind the mask. Two categories; empowered women and pressure levers, created a balancing theme against the infertility stigma.

Infertile women face social and self-stigma which threatens their psychosocial wellbeing and self-esteem. They use defensive response mechanisms and social support to mitigate these effects. Education focused on coping strategies might be helpful against infertility stigma.

• Female Infertility
• Infertility
• Qualitative study
• Stigma

• male infertility
• reproductive medicine
• subfertility
• urogynaecology

• Developing Countries
• Female
• Humans
• Infertility
• Peer Review
• Research Design
• Scoping Reviews As Topic

• Andrology
• Male infertility
• Prevalence
• Semen analysis
• Sperm analysis
• Unexplained infertility

• Centrioles/genetics
• DNA Damage/genetics
• Humans
• Infertility, Male/diagnosis
• Infertility, Male/genetics
• Infertility, Male/pathology
• Male
• Semen Analysis/trends
• Sperm Count
• Sperm Motility/genetics
• Spermatozoa/pathology
• Spermatozoa/ultrastructure

• R03 HD098314 NICHD NIH HHS
• Eunice Kennedy Shriver National Institute of Child Health and Human Development

• Demographic and health survey
• Involuntary childlessness
• Marital infidelity
• Women’s education
• Women’s health

• Adult
• Africa South of the Sahara
• Black People
• Educational Status
• Extramarital Relations/psychology
• Female
• Humans
• Logistic Models
• Marital Status/statistics & numerical data
• Marriage/statistics & numerical data

• Children
• Desire
• Public health
• Reproductive health
• Women
• sub-Saharan Africa

Infertility is detrimental to the health of married couples, especially women. Despite the consequences associated with the condition, little is done to reduce the repercussions. This study throws more light on the lived experiences of infertile women and on how they can be helped to improve their own condition.

We interviewed 30 infertile married women in the Northern and Ashanti regions of Ghana, 15 from each region. A qualitative method, phenomenological study design and thematic analysis was employed to explore their lived experiences.

Due the huge stigma, some women reported that their loved ones encouraged them to try to conceive. Others revealed that, they were considering relocating from their current communities to reduce the insults, intense pressure, stress, and stigma. Though some revealed maltreatment from their husbands and in-laws, others stated their husbands disclosed their fertility status to their own family members to avoid these families pressuring these women.

To reduce the stigma, pronatalist societies urgently need education and sensitization. Would-be couples should be counselled to have a plan to deal with such occurrences should they experience them.

• Ghana
• Infertility
• Qualitative
• Stigma
• Sub-Saharan Africa
• Women

• FDS
• Fertility desire
• Psychometrics

• depression
• infertility
• stigma
• stress
• women’s health

Sickle cell anemia (SCA) is a major genetic disease with the greatest burden in sub-Saharan Africa. To try to help reduce this burden, some churches in Nigeria conduct premarital sickle cell hemoglobin screening and refuse to conduct weddings when both individuals are identified as carriers of sickle cell trait.

This paper explores the ethical challenges involved in such denials. We assess whether churches have the right to decline to marry adults who understand the risks and still prefer to get married, and whether couples should be denied church weddings based on the risk that their child may suffer from sickle cell anemia. We examine the moral and ethical dimensions of such denials and explore the underlying socio-cultural context involving the purpose of marriage and the meaning of the wedding ceremony in societies where premarital screening is one of the few tools available to reduce the risk of having children with SCA. The potential role of the church is also examined against the background of church beliefs, the duty of the church to its members and its role in reducing the suffering of its members and /or their children.

We argue that the church should impose these burdens on couples only if doing so promotes a sufficiently compelling goal and there is no less burdensome way to achieve it. We then argue that the goal of reducing the number of individuals in Nigeria who have SCA is compelling. However, testing earlier in life offers a less burdensome and potentially even more effective means of achieving this goal. This suggests that, advocating for earlier screening and helping to support these programs, would likely better promote the church’s own goals of helping its parishioners, increasing the number of church weddings, and reducing the burden of SCA in Nigeria.

• Church wedding
• Denial
• Ethics
• Hemoglobin genotype
• Nigeria
• Premarital screening
• Sickle cell anemia

• Accra
• Depressive symptoms
• Ghana
• Sociodemographic
• Women

• Adolescent
• Adult
• Age Factors
• Aged
• Cross-Sectional Studies
• Depression/epidemiology
• Depression/etiology
• Depressive Disorder
• Educational Status
• Employment
• Female
• Ghana/epidemiology
• Humans
• Longitudinal Studies
• Middle Aged
• Pregnancy
• Prevalence
• Religion
• Socioeconomic Factors
• Stress, Psychological/epidemiology
• Stress, Psychological/etiology
• Urban Health
• Urban Population
• Women's Health
• Young Adult

• World Health Organization
• United States Agency for International Development

• Abortion
• Africa
• HIV
• communication
• decision making
• male partner
• mother-to-child transmission of HIV

• Decision Making
• Genetic Testing/ethics
• Global Health
• Humans
• Personal Autonomy
• Prenatal Diagnosis/ethics
• Sex Preselection/ethics
• Socioeconomic Factors
• Women's Health

• R00 HG006452 NHGRI NIH HHS
• R01 HG007074 NHGRI NIH HHS

There is an increasing awareness that infertility in Sub-Saharan Africa constitutes a severe social and public health problem. Few of the existing studies on infertility explicitly take into account the differences between women. However, how women experience infertility is formed by their various social positions. This research explores the implications of infertility on women’s lives in urban Gambia and aims to provide an in-depth understanding of how this relates to gender and cultural norms as well as different social positions.

Qualitative data were collected through interviews (33), group discussions (13), participatory observations (14) and informal conversations (31). Purposive and snowball sampling techniques were used to identify participants. The data was analysed thematically using NVivo 11.

Results showed that there was strong social pressure on urban women in The Gambia to procreate. Unable to conform to their gender role, women with infertility were confronted with financial problems, social stigma, as well as emotional and physical violence in their marriage. All women expressed feelings of trauma, stress and sadness. The intersectional approach used in this study highlighted how different positions influenced women’s experiences of infertility. Urban women with a high socio-economic status had a more powerful position within their marriages and the broader community, due to their financial position, professional career and, sometimes, their educational background. In contrast, women from a lower socio-economic background were more likely to be harshly confronted with the social stigma of infertility.

The lives of most women with infertility in The Gambia are characterized by social suffering resulting from gender and pro-natal norms, cultural beliefs and moral concerns, cultural practices and limited access to health care. An intersectional approach is an effective tool to inform public health and social policy since it highlights how, in specific situations, certain groups are more vulnerable than others.

• Childlessness
• Class
• Gender
• Infertility
• Intersectionality
• Social suffering
• Stigma
• The Gambia

• Childlessness
• Importance of children
• Motherhood
• Qualitative research
• Zimbabwean women

Epilepsy is a common neurological disorder in pregnancy, which is associated with increased maternal and fetal adverse outcomes. This study aimed to explore the reproductive healthcare needs of women with epilepsy before, during and after childbirth.

This was a qualitative study using a content analysis method. The study population was marital women with epilepsy in reproductive age (15–45 years) referred to Imam Hossein Hospital, Tehran, Iran. Participants were 16 women chosen using purposive sampling with the consideration of maximum variation in sampling. Semi-structured interviews were held with the participants until data saturation was reached. The data were analyzed using the content analysis method. The MAXQDA software, version 2010, was used for the management of data.

The data analysis led to the development of two categories. The first one is named ‘resilience against threats to safe pregnancy’ and has the following subcategories: (1) real physical complications and perceived (mental) conditions due to unwanted pregnancies, (2) the predisposing factors of anxiety related to safe pregnancy, (3) perceived consequences of pregnancy’, and (4) the approach to encounter perceived consequences of pregnancy. The second category is called ‘adverse experiences under inefficient supportive systems’ and has the following subcategories: (1) the insufficiency of reproductive healthcare services for women with epilepsy, (2) doubt about the advantages and disadvantages of breastfeeding, (3) stigma as a block to the treatment of the postpartum depression, and (4) playing the motherhood role under the shadow of self-esteem to lack of self-esteem.

In the prenatal, natal and postnatal duration, because of supportive system disruption and not receiving proper consultation, participants were often worried about not being able to get favorable conditions for safe pregnancy and controlling process of their pregnancy. Therefore, they often experienced unwanted pregnancy. They were also concerned about the adverse fetal outcomes. In postpartum period, they often experienced postpartum depression and were very doubtful about breastfeeding.

• Epilepsy
• Need assessment
• Pregnancy outcomes
• Reproductive health

Infertility has been shown to have considerable psychological effects on the well-being of couples, especially women. Religion has been found as a resource used by infertile women to cope with their distress. Little research has examined the influence of religious coping on psychological distress among infertile women in Ghana. This study examines the relationship between positive and negative religious coping and psychological health for women with infertility problems in Ghana.

One hundred and fifty married women who were receiving assisted reproduction care in two specialized clinics were recruited for this study. Participants were administered with the Brief Symptom Inventory and Brief Religious Coping Scale to assess psychological health associated with infertility and religious coping respectively. A hierarchical regression was performed to examine the relative contribution of the domains of psychological health (i.e. somatization, anxiety and depression) in predicting negative religious coping and positive religious.

The results showed that negative religious coping was significant and positively correlated with somatization, depression and anxiety. Furthermore, a positive relationship also existed between positive religious coping and somatization and anxiety but not depression. After controlling for age and duration of infertility, somatization and anxiety predicted positive religious coping whilst all the domains of psychological health (somatization, anxiety and depression) precited negative religious coping.

This study expanded on the existing literature by examining positive and negative religious coping with psychological distress associated with infertility for women. These results underscore the need for health professionals providing therapies for women with infertility to acknowledge and consider their religious beliefs as this influences their mental health.

• Infertility
• Psychological distress
• Quantitative
• Religious coping
• Women

• South Africa
• sexual development
• transition to adulthood
• womanhood
• young women

• Adult
• Attitude to Health
• Cultural Characteristics
• Female
• Femininity
• Feminism
• Humans
• Mothers/psychology
• Rural Population/statistics & numerical data
• Social Norms
• Social Perception
• South Africa
• Young Adult

• Wellcome Trust
• R24 AG032112 NIA NIH HHS
• R24 HD066613 NICHD NIH HHS

• Desire for children
• HIV positive patients
• HIV&AIDS
• Reproductive choices
• South Africa

• Adolescent
• Adult
• Age Factors
• Cross-Sectional Studies
• Decision Making
• Female
• HIV Infections/psychology
• Humans
• Male
• Middle Aged
• Primary Health Care
• Reproduction
• Reproductive Rights/psychology
• Sex Factors
• Socioeconomic Factors
• South Africa
• Surveys and Questionnaires
• Young Adult

• Experiences
• Male Infertility
• Perception
• Qualitative Study
• Treatment Challenges
• Women

• Access to care
• Immigrant
• Infertility
• Underserved

• health
• late reproductive span
• premature menopause
• smoking
• women

• Adult
• Female
• Humans
• India
• Menopause
• Menopause, Premature
• Prevalence
• Rural Population
• Socioeconomic Factors

• HIV/AIDS
• Human rights
• Informed consent
• Namibia
• Southern Africa
• Sterilisation

• Coercion
• Communication
• Female
• Humans
• Informed Consent
• Judgment
• Namibia
• Sterilization, Involuntary/ethics
• Sterilization, Reproductive/ethics