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

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 (<i>M</i> = 70.92, SD = 13.98). Pearson correlation analysis revealed a significant negative association between fertility-related stress and fertility-related quality of life (<i>r</i> = -0.435, <i>p</i> < 0.01), while family resilience showed a positive correlation with fertility-related quality of life (<i>r</i> = 0.377, <i>p</i> < 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], <i>p</i> < 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.