Abstract
BACKGROUND: Infertility significantly impacts couples' quality of life (QoL), with women often reporting a greater psychological burden. However, evidence regarding the effects of socioeconomic and medical variables remains mixed, particularly for couples with primary infertility in Central/Eastern Europe. This study used a dyadic approach to investigate how gender, medical history, and sociodemographic factors affect fertility-related QoL (FertiQoL) in Czech couples seeking treatment for primary infertility. PARTICIPANTS AND PROCEDURE: This cross-sectional multicenter study included 469 heterosexual couples diagnosed with primary infertility from four Czech fertility clinics. Participants completed the FertiQoL questionnaire and a sociodemographic survey. Medical data were provided by attending physicians. The Actor-Partner Interdependence Model (APIM) was employed to analyze the interdependent data from the couples. RESULTS: A significant gender effect was found, with women reporting lower total, Emotional, Mind-Body, and Social FertiQoL scores than their male partners. The cause of infertility was a key moderator: men with a male-factor or mixed-factor diagnosis reported lower Emotional and Mind-Body QoL, whereas women's scores were consistently low regardless of etiology. Prior experience with assisted reproductive technology (ART) was associated with lower Emotional scores for both partners, while lower Mind-Body scores were observed for women only. Residing in mid-sized cities and having a higher household income were associated with better QoL. Conversely, longer relationship duration was negatively associated with total, Relational, and Social scores. CONCLUSIONS: The findings underscore the necessity of integrating psychological support into standard fertility care. A dyadic, context-sensitive approach is crucial for identifying and supporting at-risk groups. Interventions should be pro-actively offered to all patients, with a targeted focus on women - especially those with prior ART experience - and men diagnosed with male-factor infertility, who represent a distinct vulnerable population requiring tailored support.