Assessing fertility-related quality of life and psychological distress among infertile women: A cross-sectional study

Abstract

Abstract Background Infertility negatively impacts quality of life and psychological well-being, yet their inter-relationship in untreated women remains unclear. Objective To explore the association between fertility quality of life (FertiQoL) and psychological distress in untreated infertile women. Materials and Methods This cross-sectional study enrolled 350 infertile women at Fateme Zahra Center, Babol, Iran (October 2023-June 2024). Participants completed FertiQoL and general health questionnaire-28 (GHQ-28) before treatment initiation. The primary outcome was FertiQoL, measured using the total FertiQoL score. Associations between FertiQoL and psychological, demographic, and infertility-related characteristics were evaluated. Results The mean age of participants was 35.7 ± 7.2 yr. The mean total FertiQoL score was 53.4 ± 3.9, with the highest score in the emotional domain (63.8 ± 11.4) and the lowest in the relational domain (41.6 ± 12.4). The mean total GHQ-28 score was 53.4 ± 9.2, and 22.0% of women exceeded the clinical threshold for psychological distress. Total GHQ-28 score was positively correlated with total FertiQoL score (r = 0.290, p < 0.001). In multivariable analysis, GHQ-28 score was the only significant predictor of FertiQoL (β = 0.287, p < 0.001), explaining 10.1% of the variance in FertiQoL scores. Conclusion Psychological distress was significantly associated with FertiQoL among infertile women. Unexpectedly, higher GHQ-28 scores were associated with higher FertiQoL scores. Given the cross-sectional design, the underlying reasons for this finding remain unclear and warrant further investigation in longitudinal and culturally diverse populations.