Access to fertility care for LGBTIQ+ and unpartnered persons: a systematic review protocol
Maria P Velez, Houda Feguery, Bailey Milne, Alessia Nicole Paparella, Lianne Gonsalves, James Kiarie, Gitau MburuIntroduction
Infertility is a major public health concern, and many individuals face substantial barriers to accessing fertility care. Across jurisdictions, regulations, eligibility criteria and funding frameworks for fertility care vary considerably, particularly in relation to lesbian, gay, bisexual, transgender, intersex and queer/questioning people (LGBTIQ+), as well as unpartnered individuals. Moreover, existing definitions and prevalence estimates of infertility are largely derived from studies of heterosexual couples which may underestimate the need for fertility care among other populations. This protocol describes a systematic review designed to synthesise current evidence on the need for and access to fertility care among LGBTIQ+ populations and unpartnered individuals as well as the policies and regulations that govern such care.
Methods and analysis
This protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. Systematic searches were conducted in MEDLINE (Ovid), Embase, Web of Science, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Global Health, as well as grey literature sources including ProQuest Dissertations & Theses, ECRI Guidelines Trust, Canadian Medical Association Journal (CMAJ) Guidelines, National Institute for Health and Care Excellence, fertility societies guidelines and Google Scholar. Eligible studies will include quantitative, qualitative, mixed-methods, narrative synthesis and typology mapping designs. Two reviewers will independently perform title/abstract and full-text screening, data extraction and quality assessment. The Critical Appraisal Skills Programme checklist will be used for qualitative studies and the Joanna Briggs Institute tools for quantitative studies. Completeness and credibility assessments will be applied to narrative syntheses and typology mappings. The primary outcomes will include measures of fertility care need, indicators of access and policy frameworks influencing service availability.
Ethics and dissemination
This study does not involve human participants. The protocol received an exemption from Research Ethics Board review by the McGill University Health Centre Research Ethics Board. Findings will be disseminated through peer-reviewed publications, conference presentations and professional networks and shared with the WHO to inform evidence-based policy.
PROSPERO registration number
CRD420251126056