Male- and female-factor infertility and partners’ quality of life during assisted reproductive technology: A dyadic actor–partner analysis

BACKGROUND: Infertility constitutes a dyadic stressor, as it inherently involves both members of a couple; nevertheless, its psychological impact is frequently evaluated from an individual perspective. We tested whether etiologic diagnosis (male and female factors) is associated with both partners' quality of life (QoL) during assisted reproductive technology (ART). METHODS: We conducted a retrospective cross-sectional study at the assisted reproduction center of a tertiary university hospital in southern Taiwan, enrolling married heterosexual couples undergoing ART who completed the Fertility Quality of Life questionnaire during treatment. Using a distinguishable-dyads actor-partner interdependence model (APIM), we estimated actor effects (one's diagnosis on one's QoL) and partner effects (one's diagnosis on the partner's QoL) in all domains. Sensitivity analyses of the APIM adjusted for age, body mass index, infertility duration, and prior embryo-transfer attempts. RESULTS: A total of 105 couples were eligible to be enrolled. Men reported higher QoL than women across domains (p < 0.01). The APIM showed a significant, asymmetric partner effect: female-factor infertility was associated with lower Mind-Body (β = -17.54, p = 0.017) and Core (β = -10.15, p = 0.045) scores in male partners. No partner effect of male-factor infertility on women's QoL was detected, and actor effects were not significant for either partner. Adjusted models yielded directionally consistent results. CONCLUSION: Infertility etiology relates to the couple's well-being in an asymmetric pattern. Female-factor infertility is linked to poorer QoL in male partners, consistent with distress from witnessing treatment and sociocultural expectations, underscoring the need for dyadic, couple-centered support during ART. Limitations include the cross-sectional design and potential selection bias arising from a high exclusion rate of incomplete dyads, which restricts generalizability.