Fig. 3.

The vicious circle between stress, QoL and altered female fertility. No cause-effect relationship can be assessed inside the intriguing relationship between stress, female infertility and QoL as it mainly depends on what stressor is considered between being infertile and an impaired QoL. Dependently on the individual perception of the problem, infertility can be a serious psychological and relationship stressor that can contribute to poor QoL levels or the clinical consequences of stress from external forms of stressful stimuli. Once infertility is manifested, difficulties arise to establish in which mechanism and because of which reason women become part of the vicious circle