Infertility, social pressure, and mental health: An empirical study based on a reproductive sociology framework

doi:10.5498/wjp.116396

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Jul 19, 2026; 16(7): 116396
Published online Jul 19, 2026. doi: 10.5498/wjp.116396

Infertility, social pressure, and mental health: An empirical study based on a reproductive sociology framework

Su-Han Huang, Hong-Ping Ji, Xiao-Han Tang, Meng Li, Si-Cong Jiang, Mei Yin

Su-Han Huang, Mei Yin, School of Humanities and Social Science, Harbin Medical University, Harbin 150081, Heilongjiang Province, China

Hong-Ping Ji, Xiao-Han Tang, Meng Li, Department of Obstetrics and Gynecology, First Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China

Si-Cong Jiang, Department of Thoracic and Endocrine Surgery, University Hospitals and University of Geneva, Geneva 450000, Switzerland

Author contributions: Huang SH and Yin M contributed to study conception and design; Ji HP and Li M were responsible for data collection and clinical background data input; Tang XH conducted the literature review and assisted in manuscript drafting; Jiang SC provided an international academic perspective and critical revision of the manuscript; Yin M supervised the study and provided methodological guidance; and all authors read and approved the final manuscript.

AI contribution statement: No AI tools or services were used in the writing, editing, or preparation of this manuscript.

Institutional review board statement: This study was approved by the Medical Ethics Committee of Harbin Medical University, approval No. HMUIRB2025031PRE.

Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: No additional data are available.

Corresponding author: Mei Yin, MD, PhD, Full Professor, School of Humanities and Social Science, Harbin Medical University, No. 157 Health Road, Harbin 150081, Heilongjiang Province, China. dryinmei@163.com

Received: December 12, 2025
Revised: January 19, 2026
Accepted: February 4, 2026
Published online: July 19, 2026
Processing time: 198 Days and 16.1 Hours

Abstract

BACKGROUND

Infertility affects a significant proportion of the global population, with profound implications for psychological well-being. Social mechanisms, including stigma and cultural expectations, play a critical role in shaping mental health outcomes, yet few studies have systematically examined these pathways within a reproductive sociology framework.

AIM

To investigate how infertility-related social pressure influences mental health outcomes and validate a comprehensive assessment tool for this purpose.

METHODS

In this cross-sectional study, 1200 patients with infertility were enrolled from 2023 to 2024 at Harbin Medical University in China. The Infertility Social Pressure and Mental Health Scale was developed and validated through confirmatory factor analysis and reliability testing. Structural equation modeling was used to evaluate social pressure as a mediator between infertility characteristics and mental health outcomes, while subgroup analyses explored gender, duration, and sociodemographic moderators.

RESULTS

The Infertility Social Pressure and Mental Health Scale demonstrated excellent psychometric properties (Cronbach’s α = 0.92, comparative fit index = 0.94, root mean square error of approximation = 0.06). Social pressure significantly mediated the relationship between infertility and psychological distress (β = 0.42, P < 0.001). Higher mean social pressure scores were found in women than men (3.78 vs 2.94, P < 0.001). Longer infertility duration, rural residence, and lower education were associated with greater vulnerability. Among pressure domains, self-imposed pressure showed the strongest correlation with depression and anxiety (r = 0.72, P < 0.001).

CONCLUSION

Social pressure represents a critical pathway linking infertility and adverse mental health outcomes. To improve patient outcomes, culturally sensitive psychosocial interventions, early screening, and support strategies are required.

Keywords: Infertility; Social pressure; Mental health; Reproductive sociology; Psychological distress

Core Tip: This study investigated the impact of infertility-related social pressure on mental health within a reproductive sociology framework. Using data from 1200 participants and a newly developed Infertility Social Pressure and Mental Health Scale, results showed that social pressure significantly mediated the relationship between infertility and psychological distress, with women and individuals with longer infertility duration experiencing higher burdens. Self-imposed pressure emerged as the strongest predictor of mental health outcomes. Culturally sensitive psychosocial interventions and routine psychological screening in infertility care are recommended to improve overall patient well-being.