Introduction
The psychosocial burden of infertility has long been underrecognized in both clinical and research settings. In response, the Fertility Quality of Life Questionnaire (FertiQoL) was developed to provide a validated, multidimensional measure for assessing the quality of life in individuals experiencing fertility problems. Authored by Jacky Boivin, Janet Takefman, Andrea Braverman, and collaborators, and published by the FertiQoL Consortium in 2011, the tool has since been cited in over 1,200 peer-citations, underscoring its global relevance and scientific rigor (Boivin et al., 2011; Akyüz et al., 2018).
This article outlines everything experts need to know about using FertiQoL in both clinical and research settings.
Key Features of the Fertility Quality of Life Questionnaire (FertiQoL)
Purpose and Use
FertiQoL evaluates quality of life for individuals and couples facing infertility, capturing their psychological, emotional, relational, and treatment-related challenges. Its primary domains reflect the mental health impact of infertility, its effect on daily functioning, and treatment satisfaction.
Target Population
The FertiQoL is intended for adults aged 18 and above, including:
Young Adults (18–24)Middle-aged Adults (25–44)Older Adults (45–64)Seniors (65+)University students and parentsIndividuals and couples undergoing fertility treatmentIts broad applicability makes it suitable for diverse populations within reproductive health contexts.
Structure
FertiQoL comprises a total of 36 items, organized as follows:
24 Core Items, divided into:Emotional (Items 1–6)Mind/Body (Items 13–18)Relational/Social (Items 7–12)Life as a Whole (Items 19–24)10 Treatment Items, divided into:Treatment Environment (Items 25–30)Treatment Burden (Items 31–34)2 Global Items assessing overall health and life satisfactionEach item is rated using a 5-point Likert scale, where higher scores indicate better quality of life. Some items are reverse-coded to ensure accurate assessment.
Scoring Method
FertiQoL utilizes a robust, multi-level Likert scale scoring system to assess fertility-related quality of life. While users can dive into the detailed scoring model (see below), the general principle is that higher scores indicate better perceived quality of life.
Item Classification
The questionnaire consists of 36 items grouped into core, treatment, and global components:
24 Core QoL Items, covering four main domains:Emotional (Items 1–6)Relational/Social (Items 7–12)Mind/Body (Items 13–18)Life as a Whole (Items 19–24)10 Treatment QoL Items, assessing:Treatment Environment (Items 25–30)Treatment Burden (Items 31–34)2 Global Items:Item 35: Overall healthItem 36: Life quality satisfactionTranslating Responses to Numerical ValuesEach item is scored on a 5-point Likert scale:
0 = Always / Very Much (worst outcome)4 = Never / Very Little (best outcome)Certain negatively phrased items are reverse-scored (e.g., Emotional domain items 1, 3, 5), which requires inverting their numerical value (e.g., 0 → 4, 1 → 3)
Calculating Domain Scores
For each domain:
Sum the item responses to get a raw scoreConvert this raw score to a standardized 0–100 scale using:Standardized Score = (Raw Score ÷ Max Domain Score) × 100
Example: If the Emotional domain (6 items) has a raw sum of 12 →
→ (12 ÷ 24) × 100 = 50
Calculating Total ScoresCore QoL Score: Average of the four core domain scoresTreatment QoL Score: Average of the two treatment domain scoresGlobal Score: Average of Item 35 and Item 36This tiered scoring structure allows researchers to evaluate both specific domains and overall fertility-related quality of life.
Interpreting ResultsInterpretation of standardized scores is as follows:
0–49 = Low quality of life50–74 = Moderate quality of life75–100 = High quality of lifeAdministration Format
The FertiQoL takes 10 – 15 minutes to administer, making it highly efficient. It can be conducted via:
Paper-based formsDigital (Online) platformsMobile AppIn-person (Interview)Its self-administered format, requiring no specialized training, enhances its practicality for busy clinical environments.
Applications of Fertility Quality of Life Questionnaire (FertiQoL)
FertiQoL is widely used in:
Screening: Identifying patients with compromised emotional and physical well-being due to infertilityMonitoring: Tracking changes across treatment cyclesTreatment Planning: Tailoring psychological support and interventionsResearch: Quantifying the impact of infertility on QoL in clinical trials and psychosocial studiesIts flexibility and comprehensiveness make it an invaluable tool in both clinical and academic environments.
Languages and Availability
FertiQoL is available in 40+ languages, including:
ArabicEnglishMandarin ChineseSpanishFrenchRussianGermanPortugueseJapaneseHindiThis multilingual availability ensures the tool's use in culturally diverse populations.
FertiQoL is free for non-commercial use, including:
Academic research (e.g., theses, dissertations, unfunded studies)Clinical psychological assessmentUniversity clinicsFor commercial use - A paid license is required, including:
Fertility tech applicationsFunded research by for-profit institutionsPharmaceutical integrationsTo request permission, contact the development team via http://fertiqol.org or email Prof. Jacky Boivin at BoivinJ@cardiff.ac.uk.
License Type: Creative Commons (CC BY)
Reliability and Validity
The FertiQoL is recognized as a highly reliable and valid instrument for assessing fertility-related quality of life. Its psychometric strength is demonstrated by a Cronbach’s alpha of 0.72–0.92, indicating excellent internal consistency across domains. Additionally, the tool has undergone multiple cross-cultural validation studies across languages and regions, ensuring global applicability.
Validation Study:
Original Validation Study (Boivin et al., 2011)PubMed Study (Ozlem Dural, 2016)Recent Validation Study (2023)Limitations and Considerations
However, despite its strengths, the FertiQoL has a few limitations:
Length: Some patients may find the 36-item questionnaire lengthySelf-report: Respondents may be influenced by social desirability bias or personal interpretationCultural Bias: While FertiQoL has been translated, cultural context can influence responses and validityPopulation Gaps: Not validated for LGBTQ+ populations; requires further adaptationLiteracy Requirement: Respondents must have sufficient reading skills to complete the tool.Other Versions and Related Questionnaires
Alternative Versions of FertiQoL
FertiQoL-Short: 15-item version for rapid assessments.FertiQoL-ED: Adapted for egg donation contexts.Complementary Questionnaires
WHOQOL-BREF: Global QoL measure.Fertility Problem Inventory (FPI): Focuses on infertility-related stress.COMPI-FPSS: Measures perceived social support.Additional Resources
For more information on the FertiQoL and to access the full questionnaire, visit the following resources:
Download the questionnaire as PDFContact Prof. Jacky BoivinOfficial FertiQoL PortalFertility quality of life tool (PubMed)Frequently Asked Questions (FAQ)
Who can use the FertiQoL?Clinicians, researchers, and healthcare providers use the FertiQoL for patients aged 18 and older with fertility issues.
How long does it take to complete the FertiQoL?Patients typically take 10–15 minutes to complete the FertiQoL, making it efficient for both clinical and research settings.
How is the FertiQoL administered?The tool can be delivered via paper-based, digital (online), mobile apps, or in-person interviews.
Is there any cost to using the FertiQoL?It is free for non-commercial use. Commercial or funded applications require a paid license.
A word from ResRef about Fertility Quality of Life Questionnaire (FertiQoL)
The Fertility Quality of Life Questionnaire (FertiQoL) offers a reliable, validated, and comprehensive tool for assessing quality of life in patients with fertility challenges. Whether you are a researcher evaluating disease impact or a clinician improving patient care, the FertiQoL reveals critical areas that need attention. Consequently, it leads to better outcomes and informed treatment decisions.
References
Boivin, J., Takefman, J., & Braverman, A. (2011). Development and validation of the FertiQoL: A fertility quality of life instrument. Human Reproduction, 26(8), 2084–2091. (link)Dural O, Yasa C, Keyif B, Celiksoy H, Demiral I, Yuksel Ozgor B, Gungor Ugurlucan F, Bastu E. Effect of infertility on quality of life of women: a validation study of the Turkish FertiQoL. Hum Fertil (Camb). 2016 Sep;19(3):186-91. Epub 2016 Aug 2. PMID: 27486018. (link)Akyüz, A., Şahin, S., Erdem, Ö., & Gözüm, S. (2018). Psychometric evaluation of the Turkish FertiQoL. Journal of Psychosomatic Obstetrics & Gynecology, 39(2), 128–137. (link)Huppelschoten, A. G., van Dongen, A. J., Verhaak, C. M., Smeenk, J. M., Kremer, J. A., & Nelen, W. L. (2013). FertiQoL: Translation and validation of the Dutch version. Facts, Views & Vision in ObGyn, 5(4), 292–300. PMID: 24753952 (link)Al Obeisat S, Hayajneh A, Hweidi I, Abujilban S, Mrayan L, Alfar R, Nashwan A, Hweidi LI. Psychometric properties of the Arabic version of the Fertility Quality of Life (FertiQoL) questionnaire tested on infertile couples in Jordan. BMC Womens Health. 2023 May 25;23(1):283. PMID: 37231403; PMCID: PMC10214630. (link)Koert E, Takefman J, Boivin J. Fertility quality of life tool: update on research and practice considerations. Hum Fertil (Camb). 2021 Oct;24(4):236-248.. Epub 2019 Aug 7. PMID: 31387469. (link)FertiQoL Consortium. (2023). FertiQoL User Manual Version 5. Cardiff University. http://fertiqol.org/wp-content/uploads/FertiQoL-User-Manual.pdf