title: Endometriosis and fertility: women's accounts of healthcare.
abstract: OBJECTIVE
  What do women with endometriosis recall being told about their fertility by their healthcare providers?
  
  
  CONCLUSIONS
  Women recalled being given varied information and advice, and gave examples of empathic and individualized care from doctors but also reported opportunities for enhancing clinical practice.
  
  
  BACKGROUND
  There is evidence of an association between endometriosis and infertility. However, the strength of this association and the mechanisms that underlie it are not yet known nor are the implications for optimum healthcare.
  
  
  METHODS
  This study used in-depth cross-sectional qualitative research methods.
  
  
  METHODS
  Women aged at least 18 years who lived in Victoria, Australia, and who had been surgically diagnosed with endometriosis were invited to participate in in-depth interviews about their experience of endometriosis. Twenty-six women of diverse backgrounds and experiences of endometriosis were interviewed from January to September 2014. Interviews were transcribed and analysed thematically using a data-driven approach.
  
  
  RESULTS
  All women encountered medical professionals who were aware of the association between endometriosis and infertility, and who were proactive in ensuring fertility was addressed within endometriosis care. Women recalled being given varied, often conflicting, information about the consequences for their fertility of an endometriosis diagnosis. While some recounted positive experiences with the way their doctor communicated with them about endometriosis and fertility, all women reported adverse experiences such as receiving insufficient or inappropriate information or having their doctor prioritize their fertility over other aspects of their care, including quality of life and symptom relief, without first consulting them.
  
  
  CONCLUSIONS
  The perspectives of the women's doctors were not sought. The findings may not translate to settings that differ from a predominantly Anglo-Saxon country with both universal public and private healthcare systems.
  
  
  CONCLUSIONS
  Women's fertility needs and priorities differ for many reasons; there can be no 'one size fits all' approach to care. Women may benefit most from endometriosis care in which they are first asked about their fertility needs and preferences and in which medical uncertainty is acknowledged.
  
  
  BACKGROUND
  K.Y. receives a scholarship from the National Health and Medical Research Council and Australian Rotary Health. J.F. is supported by a Monash Professional Fellowship and the Jean Hailes Professional Fellowship which is funded by Perpetual Trustees Pty Ltd. The authors have no conflicts of interest to declare.
  
  
  BACKGROUND
  Not applicable.
authors.affiliation: The Jean Hailes Research Unit, Monash University, 1st Floor, 549 St Kilda Rd, Melbourne, Victoria 3004, Australia kate.young@monash.edu.
authors.forename: K
authors.initials: K
authors.lastname: Young
authors.affiliation: The Jean Hailes Research Unit, Monash University, 1st Floor, 549 St Kilda Rd, Melbourne, Victoria 3004, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Fisher
authors.affiliation: The Jean Hailes Research Unit, Monash University, 1st Floor, 549 St Kilda Rd, Melbourne, Victoria 3004, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Kirkman
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004715:Endometriosis / Q000150:complications*; D005260:Female; D005298:Fertility; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007247:Infertility, Female / Q000150:complications* / Q000523:psychology; D017060:Patient Satisfaction; D011787:Quality of Health Care; D011788:Quality of Life; D014739:Victoria
keywords: delivery of healthcare; endometriosis; fertility; infertility; qualitative research