Abstract
Background/Objectives: Infertility imposes substantial psychosocial burdens on affected individuals, often resulting in a decline in quality of life comparable to that experienced in chronic diseases. Exploring lifestyle and health awareness-related factors is essential to develop complex, multidisciplinary approaches. This study investigated the associations between the components of 24-h movement behaviour (physical activity, sedentary lifestyle, sleep), health literacy, fertility awareness, and general and infertility-specific quality of life. Additionally, the study assessed whether these factors could predict quality of life outcomes in women living with infertility. Methods: A cross-sectional study was conducted using questionnaire-based data collection in four fertility centres in Hungary. The convenience sample included 361 women aged 18-45 years with a documented infertility diagnosis. Validated questionnaires were used to assess health literacy (BRIEF), fertility awareness (FAS), physical activity (GPAQ-H), sleep quality (AIS), and quality of life (WHOQOL-BREF and FertiQoL). Data analysis included Kolmogorov-Smirnov tests, Spearman correlations, and generalised linear modelling (GLM), with statistical significance set at p < 0.05. Results: Based on the FAS, 77.8% of participants (n = 274) self-reported being adequately informed; however, objective knowledge scores accounted for only 48.5% of the possible total, indicating limited knowledge. Fertility awareness positively correlated with recreational physical activity (ρ = 0.156; p = 0.003). Recreational physical activity showed low but significant positive associations with all quality-of-life dimensions (e.g., psychological well-being: r = 0.177; p ≤ 0.002), whereas sedentary time was negatively associated with psychological well-being (r = -0.109) and social relationships (r = -0.118). Sleep duration correlated positively while sleep quality problems correlated negatively with FertiQoL scores (r = -0.339; p ≤ 0.001). Better sleep quality, lower sedentary time, and higher health literacy were positive predictors of infertility-specific quality of life, whereas higher fertility awareness showed a paradoxical adverse effect. Conclusions: These findings highlight the role of 24-h movement behaviour and health awareness in improving quality of life among women with infertility. The study supports the need for tailored, multi-component lifestyle interventions to promote physical, mental, and psycho-social well-being.