Infertility-related stress and quality of life among infertile women with polycystic ovary syndrome: Does body mass index matter?

Objective: Infertility and obesity are common among women with Polycystic ovary syndrome (PCOS) and related to poor quality of life (QoL). Obesity may confer an elevated adverse effect of infertility-related stress given its relationship with increased susceptibility to stress. This study aimed to investigate the association of infertility related stress with QoL among infertile women with PCOS, and to evaluate whether body mass index (BMI) modifies this association. Methods: A cross-sectional study was conducted with 306 participants recruited from the infertility outpatient clinic. A self-administered, structured questionnaire including COMPI Fertility Problem Stress Scale (COMPIFPSS) and the modified PCOS health-related QoL questionnaire (MPCOSQ) was conducted in this study. The moderation model was conducted by the PROCESS macro using SPSS. Results: The mean score of QoL was 142.67 (SD = 20.11), ranged from 93 to 183 (theoretical range = 30-210). QoL was negatively associated with infertility-related stress (r =-0.373, P < 0.001). Moderation analysis indicated that the interaction term between infertility-related stress and BMI significantly predicted QoL (beta =-0.154, P = 0.005, f(2) = 0.03) as well as emotional disturbance (beta =-0.170, P = 0.002, f(2) = 0.04). Specifically, higher BMI significantly exacerbated the effect of infertility-related stress on QoL and emotional disturbance. Conclusion: Infertile women with PCOS experienced poor QoL. The moderation role of BMI provides a better understanding of individual difference in relationship between infertility-related stress and QoL. Interventions aiming to improve QoL among infertile women with PCOS should focus on alleviating infertility-related stress, especially among women with high BMI.