Psychological Capital Mediates the Impact of Psychological Distress on Fertility-Related Quality of Life in IVF Patients: A Cross-Sectional Study in China

Background Assisted reproductive technology (ART) is increasingly recognized as an essential treatment for infertility, but its physically and emotionally demanding nature often results in elevated emotional strain and impaired fertility-related quality of life (FertiQoL). Psychological capital (PsyCap)—a composite of self-efficacy, hope, optimism, and resilience—has shown promise as a protective factor in stressful contexts. However, its mediating role between emotional strain and FertiQoL in ART populations remains insufficiently understood. Methods A cross-sectional study was conducted among 449 women undergoing in vitro fertilization (IVF) at a major reproductive medical center in China. Participants completed standardized assessments: the Depression Anxiety Stress Scale (DASS-21), the Fertility Quality of Life Questionnaire (FertiQoL), and the Positive Psychological Capital Questionnaire (PPQ-26). Correlation analyses, hierarchical regression models, and mediation analysis (using PROCESS macro in SPSS) were employed. Results Psychological stress was significantly negatively correlated with FertiQoL (r = -0.549, p < 0.01), while PsyCap was positively correlated with FertiQoL (r = 0.514, p < 0.01) and negatively associated with stress (r = -0.420, p < 0.01). Mediation analysis confirmed that PsyCap partially mediated the relationship between emotional strain and FertiQoL (indirect effect = -0.157, 95% CI [-0.211, -0.109]). Conclusions Psychological capital serves as a partial mediator in the link between psychological stress and fertility quality of life among IVF patients. Interventions aimed at enhancing PsyCap may provide an effective strategy to mitigate emotional distress and improve ART-related quality of life outcomes.