Effects of infertility on relationship quality and mental health outcomes in sub-Saharan Africa: A scoping review
5 affiliations
- 1African Population and Health Research Center, Nairobi, Kenya.
- 2Gender and Women's Health, Nossal Institute for Global Health, School of Population and Global Health, University of Melbourne, Melbourne, Australia.
- 3Kenya Medical Research Institute, Nairobi, Kenya.
- 4School of Business and Economics, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
- 5Beshi King Development Services Limited, Abuja, Nigeria.
Abstract
Infertility is associated with significant psychosocial challenges, and relationship strain yet remains underprioritized in sub-Saharan African policy and research. We conducted a scoping review to examine the effects of infertility on relationship quality and mental health outcomes among people experiencing infertility in sub-Saharan Africa. We utilized the Joanna Briggs Institute methodology for scoping reviews and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. We searched databases including PubMed/MEDLINE, CINAHL, Web of Science, JSTOR, Scopus, Academic Search Complete, PsycINFO, and the Psychology and Behavioral Science Collection. Eligible articles focused on the effects of infertility on mental health and relationship quality in women, men, and couples experiencing infertility and were published between January 2000 and November 2025. We extracted data and conducted an iterative narrative synthesis. We included 70 articles: 36 quantitative, 5 mixed methods, and 29 qualitative. Four key themes emerged, which fit within the socio-ecological model: 1) infertility and relationship quality, 2) infertility and mental health, stigma and discrimination, 3) adaptive coping mechanisms, and 4) maladaptive coping mechanisms. Infertility was associated with anxiety, depression, and emotional distress. Studies revealed profound experiences of isolation and grief over unfulfilled reproductive goals, compounded by societal pressures. Diminished relationship quality was a common outcome among individuals with infertility, manifesting as intimate partner violence, verbal and emotional abuse, loss of intimacy, infidelity, and separation or divorce. Couples with infertility attempted multiple care pathways, including religious, biomedical, and traditional care. Lack of psychosocial support was common, and individuals often coped through substance and drug abuse, isolation, and active avoidance. Complexity of the relationship between infertility, mental health, and relationship quality, reinforces the need for urgent integrated individual and structural interventions that promote holistic fertility care and social support.
Related
- Mapping antimicrobial stewardship principles in HIV positive patients in sub-Saharan Africa: a systematic scoping review protocol
- Cardiovascular disease risk prediction models for people living with HIV in Sub-Saharan Africa: A scoping review protocol
- Locally advanced gastrointestinal stromal tumors: Surgical strategies and outcomes in a referral hospital in Sub-Saharan Africa
- The relationship between autistic camouflaging and mental health: a scoping review
- Characterizing multidimensional facial synchrony for relationship quality detection
BibTeX
@article{juma2026effects,
title = {{Effects of infertility on relationship quality and mental health outcomes in sub-Saharan Africa: A scoping review}},
author = {Kenneth Juma and Cynthia Kairu and Merlyne Akwir Nungo and Merryline Chepkoech and Easter Olwanda and Sally Atieno Odunga and Ramatou Ouedraogo and Boniface Ayanbekongshie Ushie and Yohannes Dibaba Wado},
journal = {PLOS Global Public Health},
year = {2026},
month = nov,
doi = {10.1371/journal.pgph.0005923},
url = {https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005923},
note = {CC BY},
}
RIS
TY - JOUR
TI - Effects of infertility on relationship quality and mental health outcomes in sub-Saharan Africa: A scoping review
AU - Kenneth Juma
AU - Cynthia Kairu
AU - Merlyne Akwir Nungo
AU - Merryline Chepkoech
AU - Easter Olwanda
AU - Sally Atieno Odunga
AU - Ramatou Ouedraogo
AU - Boniface Ayanbekongshie Ushie
AU - Yohannes Dibaba Wado
PY - 2026
DA - 2026/11/10
JO - PLOS Global Public Health
DO - 10.1371/journal.pgph.0005923
UR - https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005923
AB - Infertility is associated with significant psychosocial challenges, and relationship strain yet remains underprioritized in sub-Saharan African policy and research. We conducted a scoping review to examine the effects of infertility on relationship quality and mental health outcomes among people experiencing infertility in sub-Saharan Africa. We utilized the Joanna Briggs Institute methodology for scoping reviews and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. We searched databases including PubMed/MEDLINE, CINAHL, Web of Science, JSTOR, Scopus, Academic Search Complete, PsycINFO, and the Psychology and Behavioral Science Collection. Eligible articles focused on the effects of infertility on mental health and relationship quality in women, men, and couples experiencing infertility and were published between January 2000 and November 2025. We extracted data and conducted an iterative narrative synthesis. We included 70 articles: 36 quantitative, 5 mixed methods, and 29 qualitative. Four key themes emerged, which fit within the socio-ecological model: 1) infertility and relationship quality, 2) infertility and mental health, stigma and discrimination, 3) adaptive coping mechanisms, and 4) maladaptive coping mechanisms. Infertility was associated with anxiety, depression, and emotional distress. Studies revealed profound experiences of isolation and grief over unfulfilled reproductive goals, compounded by societal pressures. Diminished relationship quality was a common outcome among individuals with infertility, manifesting as intimate partner violence, verbal and emotional abuse, loss of intimacy, infidelity, and separation or divorce. Couples with infertility attempted multiple care pathways, including religious, biomedical, and traditional care. Lack of psychosocial support was common, and individuals often coped through substance and drug abuse, isolation, and active avoidance. Complexity of the relationship between infertility, mental health, and relationship quality, reinforces the need for urgent integrated individual and structural interventions that promote holistic fertility care and social support.
SN - 2767-3375
ER -