Self-Esteem and Quality of Life Among Women Undergoing IVF-ET: Mediating Role of Coping Strategies

Objectives: The study aims to understand how coping strategies mediate the relationship between self-esteem and the Fertility Quality of Life (FertiQoL) in women preparing for in vitro fertilisation (IVF)-embryo transfer (ET). Material and Methods: A cross-sectional study was conducted among 346 women preparing for IVF in Kerala, India. Data were collected using a personal data schedule, the FertiQoL questionnaire, the Rosenberg self-esteem scale, and the Copenhagen Multi-Centre Psychosocial Infertility (COMPI) coping strategy scale. Mediation analysis was performed using the PROCESS macro for SPSS (Model 4). Results: The result shows that the total effect of self-esteem on FertiQoL was significant (b = 2.2454, SE = 0.1363, t (346) = 16.4782, p <0.001, 95% CI [1.9774, 2.5135], β = 0.6596). The direct effect of self-esteem on FertiQoL also remained significant (b = 1.6343, SE = 0.1487, t (346) = 10.9940, p <0.001, 95% confidence interval (CI) [1.3419, 1.9267], β = 0.4803). This suggests that self-esteem continues to uniquely contribute to the FertiQoL, independent of its effect on coping strategies. The indirect effect of self-esteem on FertiQoL through coping strategies was statistically significant (b = 0.6111, Bootstrap SE = 0.1041, 95% bias-corrected CI [0.4147, 0.8285] β = 0.1796). Conclusion: These findings suggest that coping strategies serve as a partial mediator in the relationship between self-esteem and FertiQoL for women undergoing IVF. Consequently, interventions focused on enhancing self-esteem and coping strategies may improve the overall QoL for women in IVF treatment.