Effects of infertility on relationship quality and mental health outcomes in sub-Saharan Africa: A scoping review

Infertility is associated with significant psychosocial challenges, and relationship strain yet remains underprioritized in sub-Saharan African policy and research. We conducted a scoping review to examine the effects of infertility on relationship quality and mental health outcomes among people experiencing infertility in sub-Saharan Africa. We utilized the Joanna Briggs Institute methodology for scoping reviews and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. We searched databases including PubMed/MEDLINE, CINAHL, Web of Science, JSTOR, Scopus, Academic Search Complete, PsycINFO, and the Psychology and Behavioral Science Collection. Eligible articles focused on the effects of infertility on mental health and relationship quality in women, men, and couples experiencing infertility and were published between January 2000 and November 2025. We extracted data and conducted an iterative narrative synthesis. We included 70 articles: 36 quantitative, 5 mixed methods, and 29 qualitative. Four key themes emerged, which fit within the socio-ecological model: 1) infertility and relationship quality, 2) infertility and mental health, stigma and discrimination, 3) adaptive coping mechanisms, and 4) maladaptive coping mechanisms. Infertility was associated with anxiety, depression, and emotional distress. Studies revealed profound experiences of isolation and grief over unfulfilled reproductive goals, compounded by societal pressures. Diminished relationship quality was a common outcome among individuals with infertility, manifesting as intimate partner violence, verbal and emotional abuse, loss of intimacy, infidelity, and separation or divorce. Couples with infertility attempted multiple care pathways, including religious, biomedical, and traditional care. Lack of psychosocial support was common, and individuals often coped through substance and drug abuse, isolation, and active avoidance. Complexity of the relationship between infertility, mental health, and relationship quality, reinforces the need for urgent integrated individual and structural interventions that promote holistic fertility care and social support.