ArticleBMC women's health2026
Coping strategies as mediators of the relationship between fertility quality of life and psychological resilience among infertile patients: a cross-sectional mediation analysis.
Article in BMC women's health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Gender Differences in Anxiety, Depression, and Fertility-Related Quality of Life Among Infertile Couples: A Cross-Sectional Study.Journal of clinical medicine · 2026Article
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Abstract
backgroundInfertility is a major reproductive health issue affecting childbearing-age couples worldwide. Factors contributing to its increasing prevalence include delayed marriage and childbearing decisions, as well as exposure to environmental pollutants. In addition to directly causing fertility problems, infertility also negatively affects family relationships by causing psychological trauma, such as anxiety and depression, thereby reducing quality of life. Emotional state, fertility-related stress, fertility quality of life (FertiQoL), and coping strategies are associated with psychological resilience. However, according to existing studies, the relationships among coping strategies, FertiQoL, and psychological resilience, as well as the synergistic pathways between the former two and psychological resilience, remain unclear. The purpose of this study is to investigate the associations among coping strategies, FertiQoL, and psychological resilience. Additionally, it aims to investigate whether different coping strategies serve as a mediator between FertiQoL and psychological resilience.
methodThis study employed a cross-sectional research design and purposive sampling method. A total of 222 patients with infertility who visited a tertiary-level hospital in Hunan Province between January and December 2019 were selected as the study subjects. We measured psychological resilience specifically in those who reported an unfulfilled wish for a child. Additionally, FertiQoL and coping strategies were assessed. We used Pearson's product moment correlation to examine the association of psychological resilience, FertiQoL and coping strategies. Using the Process v4.1 model, we examined the mediating function of various coping strategies in the association between psychological resilience and FertiQoL, and employed stratified multiple regression analysis to investigate the factors influencing psychological resilience.
resultsIn total, 222 patients with infertility presented psychological resilience scores that were below the Chinese norm (M = 66.34; SD = 13.90) and were moderately low (M = 60.42; SD = 12.18). Pearson's correlation analyses revealed significant bivariate associations among the study variables. FertiQoL demonstrated a weak but statistically significant negative correlation with psychological resilience (r =-.149, p < .05), whereas both positive coping (r = .261, p < .05) and meaning-based coping strategies (r = .377, p < .05) showed moderate positive correlations. In contrast, neither active avoidance (r =-.029, p > .05) nor passive avoidance strategies (r = .115, p > .05) were significantly associated with psychological resilience. In the mediation analysis adjusted for covariates, introducing positive and meaning-based coping strategies as mediators significantly attenuated the standardized coefficient of the FertiQoL-resilience association, which decreased from B=-0.172 to B=-0.329. These results demonstrate that both coping strategies play a significant mediating role in the relationship between FertiQoL and psychological resilience, with positive coping strategies having an indirect effect on psychological resilience of 0.074 (95% CI [0.010, 0.140]) and meaning-based coping strategies having an indirect effect of 0.083 (95% CI [0.030, 0.149]). The magnitude of the mediated effect was 34.81% overall.
conclusionInfertility patients' psychological resilience and FertiQoL are related, and positive coping and meaning-based coping strategies have some mediating effects on this relationship, indicating that these strategies may be important in reducing the detrimental effects of FertiQoL on psychological resilience. Positive coping and meaning-based coping strategies have been shown to be effective at preserving patients' psychological well-being. These findings serve as a foundation for future research into focused intervention programs.
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