The effect of infertility-related stress on fertility-related quality of life in reproductive-age married women with endometriosis: the mediating role of family resilience

ABSTRACT This study investigated fertility-related quality of life among married women of reproductive age (20–45 years) with endometriosis-associated infertility, focusing on the mediating role of family resilience between infertility-related stress and fertility-related quality of life. A cross-sectional survey was conducted between January 2024 and April 2025 at a tertiary hospital gynecology and reproductive center in Guangdong Province, China. Data were collected via structured questionnaires and analyzed using IBM SPSS Statistics 25.0 and AMOS 26.0. Results indicated moderate levels of fertility-related stress (M = 70.92, SD = 13.98). Pearson correlation analysis revealed a significant negative association between fertility-related stress and fertility-related quality of life (r = -0.435, p < 0.01), while family resilience showed a positive correlation with fertility-related quality of life (r = 0.377, p < 0.01). Mediation analysis demonstrated that family resilience partially mitigated the negative impact of stress on fertility-related quality of life (standardized indirect effect = -0.11, 95% CI [−0.18, −0.06], p < 0.001). The findings suggest that while fertility-related stress directly impairs fertility-related quality of life in this population, family resilience serves as a protective buffer. Clinically, interventions aimed at strengthening family support and adaptive capacity may help reduce stress and improve well-being in women with endometriosis-associated infertility. Acknowledgments The authors would like to thank the patients who participated in this study for their valuable feedback. Disclosure statement No potential conflict of interest was reported by the author(s). Author’s contribution All authors contributed to the study design. Guifang Bai and Fang Fang were responsible for the study conception and design, and drafted the manuscript. Jiaqi Wu, Yujie Gan, Ping Zhou, and Caixia Xu acquired and interpreted the data. Xiaowan Luo and Cuimei Luo provided administrative, technical, or material support. Yixin Luo participated in study supervision, data analysis, and final review of the research manuscript. All authors contributed to the manuscript preparation. All authors reviewed and approved the final draft of the manuscript. Data availability statement The datasets generated and analyzed during the current study are not publicly available due to confidentiality agreements but are available upon reasonable request from the corresponding author. Ethics approval and consent to participate This study was approved by the Ethics Committee of Boai Hospital of Zhongshan (Approval No: KY-2022–010-11). Written informed consent was obtained from the participants. The research was conducted in full accordance with the ethical standards outlined in the Declaration of Helsinki, ensuring the protection of participants’ rights and well-being. Supplementary material Supplemental data for this article can be accessed online at https://doi.org/10.1080/13548506.2025.2584368.