Abstract
             Background:  Health related quality of life (QoL) has now been considered as a main tool for  outcome measurement in infertility. The present study aimed to determine the  association between general and specified QoL with different psychological  aspects of self-esteem, social support, sexual satisfaction, and marital  satisfaction in a sample of Iranian infertile couples. 
 Method:  This cross-sectional study was conducted on 385 infertile couples referred to  the Fatemieh Hospital in Hamadan City, western Iran in 2012.To measure the  self-esteem, the Iseng test was used. The social support scaling developed by  Cassidy and Long was used for assessment of social support. The sexual  satisfaction was also assessed by the Lindaberg questionnaire. For assessing the  general QoL state, the WHO-QoL-BREF and FertiQoL tools were employed.
  Results:  Self-esteem scores were lower in the couples with longer infertility duration.  The social support mean score was lower in low income couples. Those with higher  educational level, shorter infertility duration, and higher income were more  satisfied from their marital relationships. Besides, we revealed that the  previous failed efforts for treatment of infertility were adversely associated  with the lower social support and sexual satisfaction. The higher educational  level, higher monthly income, living in urban area, shorter duration of marriage  and infertility, and male gender were associated with better    QoL status in  the most components.Associations  between  QoL   and self-esteem, social support, sexual satisfaction, and marital satisfaction  were significant (P<0.05). 
  Conclusion:  The QoL status in infertile couples is directly associated with their self-esteem, social support, sexual satisfaction, and marital  satisfaction.