The mediating effect of family support on stigma and psychological distress among female patients with infertility: a cross-sectional study

Infertility affects women’s physical health and imposes significant levels of stigma and psychological distress. While family support is a protective factor for mental health, its specific role in the pathway between stigma and psychological distress among female patients with infertility has not been fully elucidated. Examining this pathway is crucial for formulating targeted family interventions, as clarifying these relationships is essential for improving the mental well-being of these patients. This study adopted a cross-sectional design and convenience sampling of 204 female patients with infertility, ages 23 to 43, who visited the Reproductive Medicine Department of a tertiary A-grade hospital in Ganzhou City, Jiangxi Province, between February and March 2025. The Infertility Stigma Scale (ISS), Distress Thermometer (DT), and the Family Adaptation, Partnership, Growth, Affection, and Resolve (Family APGAR) scale were administered to the participants. Mediation analysis was conducted using the PROCESS macro for SPSS 25.0. Female patients with infertility reported relatively high levels of perceived stigma. Pearson correlation analysis showed that stigma was positively correlated with psychological distress (r = 0.561, p < 0.05) and negatively correlated with family support (r = − 0.600, p < 0.05) and psychological distress was negatively correlated with family support (r = − 0.432, p < 0.05). Mediation effect analysis indicated that the total effect of stigma on psychological distress was 0.204 (95% CI: 0.142–0.266), the effect size of the direct impact of stigma on psychological distress was 0.165 (95% CI: 0.094–0.235), and the mediating effect of family support indirectly influencing psychological distress was 0.039 (95% CI: 0.005–0.077), accounting for 19.1% of the total effect. Family support partially mediates the association between perceived stigma and psychological distress among female patients with infertility. These findings suggest that clinical interventions should focus on individual patients while also incorporating family-centered approaches. Assessing and bolstering the quality of family support could be a key strategy for buffering the negative psychological impact of infertility-related stigma. However, the findings should be interpreted with caution because of the cross-sectional design, which precludes causal inference, and the single-center sample, which may limit generalizability.