Quality of Life in Infertility: What a Czech Multicentre Study Reveals

Infertility is more than a medical diagnosis. For many people, it becomes a long-term life experience that affects emotions, relationships, everyday functioning, and social life. While fertility care naturally focuses on treatment outcomes, it is just as important to understand how patients feel during the journey—because psychological strain can influence persistence with treatment and the likelihood of discontinuation.

A Czech multicentre study, co-authored with the participation of our clinic Reprofit, explored fertility-related quality of life (FertiQoL)—a measure designed specifically to capture how infertility impacts wellbeing. Importantly, the research looks at couples as a unit. Infertility is lived “as two,” and one partner’s experience can affect the other’s wellbeing.

Study overview

The study included 469 heterosexual couples with primary infertility, recruited from four Czech fertility centres. Couples completed the FertiQoL questionnaire and a sociodemographic survey; physicians provided relevant clinical data. Data were collected between July 2020 and February 2022.

To analyse the results, researchers used the Actor–Partner Interdependence Model (APIM). This approach is particularly helpful in fertility care because it captures not only how factors affect an individual, but also how they may affect their partner—reflecting the shared nature of infertility-related stress.

What the study found

1) Women reported a higher burden across most areas

The most consistent finding was that women reported lower FertiQoL than men overall, particularly in the Emotional, Mind–Body, and Social domains. There was no statistically significant gender difference in the Relational domain.

In real life, this often looks like:

- stronger emotional impact (anxiety, sadness, frustration),

- spillover into everyday functioning (energy levels, concentration, routine, a sense that life is “on hold”),

- increased social strain (pressure from others, intrusive questions, withdrawal or isolation).

2) Male-factor infertility can have a strong impact on men

The study also challenges a common assumption: that men are less affected. It shows that in cases of male-factor or mixed infertility, men had significantly poorer outcomes in the Emotional and Mind–Body domains.

In practice, a male-factor diagnosis may trigger shame, threaten self-identity, or create a sense of “being at fault.” This can be particularly difficult because men are often less likely to ask for support—meaning distress can remain hidden.

3) Previous ART experience is linked to worse emotional wellbeing

Another important insight: previous ART experience was associated with poorer emotional wellbeing in both partners, and with poorer Mind–Body outcomes particularly in women (physical wellbeing, mental load, and day-to-day functioning).

This can be a turning point in the fertility journey—when motivation becomes fragile and the risk of burnout or treatment drop-out increases.

4) Social and economic context also plays a role

Beyond medical factors, the study found associations suggesting that everyday context influences coping:

- higher FertiQoL among people living in mid-sized cities (approx. 50,000–200,000 inhabitants) compared with small towns/villages,

- higher income linked to better Mind–Body scores,

- longer relationship duration associated with poorer overall, relational, and social FertiQoL outcomes.

These patterns suggest that resources, social environment, and long-term strain may shape how couples experience infertility—and can help clinics better understand where additional sensitivity and communication may be needed.

What this means for fertility care

This study reflects what many clinics see in practice: infertility affects both partners—sometimes differently, and sometimes silently. Emotional burden often increases with time and repeated treatment experience.

A practical takeaway is that clinics can strengthen care by:

- paying attention to emotional strain early and repeatedly (especially after unsuccessful cycles),

- normalising conversations about wellbeing as a natural part of the treatment pathway,

- recognising higher-risk situations (e.g., male-factor infertility, repeated ART attempts) where distress may be more likely or less visible,

- supporting couples as a unit, not as two separate individuals.

At Reprofit, we consider patient experience and psychological safety an important part of respectful fertility care—alongside clinical excellence, empathy, and clear communication.

respectful fertility care—alongside clinical excellence, empathy, and clear communication.

 

With thanks to our Reprofit colleagues for their contribution and co-authorship:

Jana Daňková Kučerová and Andrea Rákosová Kagánková (Reprofit International Ostrava), Pavel Otevřel and Jan Štelcl (Reprofit International Brno).