Positive Dyadic Coping and Infertility Stress: The Mediating Effect of Relational Resilience in Iranian Women Undergoing Infertility Treatment

Abstract

Background: Infertility represents a significant crisis in married life, leading to serious intrapersonal and interpersonal challenges, with many infertile women experiencing psychological and marital difficulties. Objectives: In Iran, few studies have examined communication factors influencing infertility stress. This study aimed to better understand the variables affecting infertility stress and to test the mediating role of relational resilience in the relationship between dyadic coping and infertility stress among women undergoing infertility treatment in Kashan. Methods: A correlational study using structural equation modeling (SEM) was conducted. The statistical population comprised infertile women who attended an infertility center in Iran in 2023. A total of 218 participants were selected through purposive sampling and completed the Relational Resilience Questionnaire, Dyadic Coping Inventory (DCI), and Fertility Problems Inventory (FPI). Data were analyzed using AMOS 24 and SPSS 24. Results: The final mediation model demonstrated good fit indices (all > 0.90). Dyadic coping positively influenced relational resilience (β = 0.67, P < 0.001), which in turn negatively affected infertility stress (β = -0.51, P < 0.001), indicating full mediation. Subscale analyses confirmed these relationships: Relational resilience and dyadic coping were positively associated with their respective dimensions, while infertility stress was positively linked to social, relational, sexual concerns, and the need for parenthood. These results suggest that dyadic coping among infertile women and their husbands can enhance relational resilience, thereby reducing infertility-related stress. Conclusions: Although infertility stress affects multiple aspects of a couple's life, positive dyadic coping and relational resilience play a protective role. The findings provide valuable insights for therapists working with infertile couples, highlighting the importance of strengthening dyadic coping and relational resilience to mitigate stress.