Resilience, marital quality and quality of life in infertile couples: application of an actor-partner interdependence mediation model

Resilience and marital quality are closely interrelated among individuals experiencing infertility, and both constructs have been shown to positively predict fertility-related quality of life (FRQoL). However, the mutual influences between partners within infertile couples have received limited attention. This study aimed to explore the mediating role of marital quality in the relationship between individual resilience and FRQoL within a dyadic framework. A cross-sectional survey was conducted with 984 infertile couples recruited from the First Affiliated Hospital between May 2019 and December 2023. Resilience, marital quality, and FRQoL were assessed using the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), the unidimensional Quality Marriage Index (QMI), and the Fertility Quality of Life (FertiQoL) scale, respectively. Paired-sample t-tests indicated that female partners reported significantly lower scores than male partners across all three constructs. Utilizing the actor-partner interdependence mediation model (APIMeM), dyadic relationships among these variables were examined. Results demonstrated that resilience directly and positively predicted FRQoL for both oneself and one's partner. Additionally, resilience indirectly predicted FRQoL by positively influencing marital quality within couples. However, marital quality significantly predicted only one's own FRQoL, without significant cross-partner effects. These findings have several important implications. First, marital quality represents a crucial intervention target for enhancing FRQoL among infertile couples. Second, observed gender disparities indicate that female partners may require more targeted psychological support. Finally, although men generally report higher scores in resilience, marital quality, and FRQoL, enhancing marital quality is nonetheless beneficial for both partners individually. Therefore, psychological interventions should adopt a couple-centered approach, simultaneously addressing emotional well-being and relationship dynamics to optimize outcomes for both partners.