Development and validation of the infertility stress scale for Korean women

Infertility imposes multifaceted stress on women, influencing their emotional well-being, treatment adherence, and quality of life. Accurate assessment is essential for guiding targeted interventions. Existing infertility stress scales developed in the 1990s no longer capture the contemporary experiences of Korean women with infertility. This study aims to develop and validate the Infertility Stress Scale (ISS) to assess contemporary infertility-related stress among Korean women, while ensuring practical applicability in clinical and research settings. Scale items were developed via a review of existing instruments, a clinician survey, and in-depth interviews, followed by expert evaluation, content validation, and pilot testing. The finalized version was then administered to 300 women with infertility. Construct validity was assessed using exploratory and confirmatory factor analyses, criterion validity was examined via correlations with the Fertility Problem Inventory (FPI) and Perceived Stress Scale-10 (PSS-10), and reliability was assessed through internal consistency. Preliminary T-score reference values were established to enable standardized interpretation. The finalized 26-item ISS comprised four factors: psychological, marital relationship, social relationship, and treatment-related stresses. Factor analyses confirmed a robust four-factor structure (comparative fit index = 0.929, Tucker–Lewis index = 0.921, root mean square error of approximation = 0.059). Internal consistency was high (Cronbach’s α = 0.824–0.920; overall α = 0.939), and criterion validity was supported via significant correlations with the FPI and PSS-10. The ISS is a reliable and valid instrument designed to capture the lived experiences of women experiencing infertility, offering a comprehensive and standardized measure of infertility-related stress that may support clinical and research applications.