Psychometric Evaluation of the Fertiqol Questionnaire Among Infertile Individuals and Couples in Uganda: Findings From a Tertiary Hospital in Peri-urban Kampala

Abstract Background: Infertility, affecting approximately 1 in 6 couples globally, is associated with profound psychosocial distress for both men and women. The Fertility Quality of Life (FertiQoL) instrument is a validated tool for assessing fertility-specific quality of life. However, its psychometric properties have not been evaluated in Uganda. This study aimed to assess the psychometric properties of the FertiQoL instrument among a sample of Ugandan individuals and couples experiencing infertility. Methods: A cross-sectional study took place at the fertility clinic in a peri-urban tertiary hospital in Kampala between March and May 2023. The English version of FertiQoL was translated into Luganda using standardized forward-backward translation procedures. The English and Luganda versions were administered to 120 participants. Internal consistency was measured using Cronbach’s alpha. Exploratory and confirmatory factor analyses (CFA) assessed construct validity. Convergent validity was examined via average variance extracted (AVE). Results: The FertiQoL demonstrated acceptable internal consistency across all subscales (α > 0.70), with the relational subscale showing the highest reliability (α = 0.86). Factor loadings for all items ranged from 0.30 to 0.86. Initial AVE values indicated acceptable convergent validity for the relational (0.56) and social (0.487) subscales, while the emotional (0.387) and mind-body (0.306) subscales fell below the threshold of 0.50. CFA conducted after removing items with low factor loadings improved AVE values for emotional (0.443) and mind-body (0.416) subscales, while relational (0.655) and social (0.551) reached acceptable levels. However, model fit indices remained suboptimal (CFI = 0.686; SRMR = 0.086; RMSEA = 0.202), potentially due to the limited sample size and cultural-contextual influences on item interpretation. Conclusions: The FertiQoL demonstrated satisfactory internal consistency. Construct validity findings were mixed, with relational and social subscales showing stronger psychometric properties than emotional and mind-body domains. Further validation studies with larger, more diverse samples and iterative cultural adaptation are recommended to enhance the instrument’s applicability in the Ugandan context.