Stress associated with the inability to have a child is linked to four aspects of marriage and to five dimensions of life quality. Data come from 157 couples who met a standard medical definition for infertility. Wives and husbands were interviewed independently, and most of the following findings apply to both. A causal model suggests that fertility problem stress has direct effects that increase marital conflict and decrease sexual self-esteem, satisfaction with own sexual performance, and frequency of sexual intercourse. Also, fertility problem stress has both direct and indirect effects (via the marriage factors) that decrease evaluations of life-as-a-whole, self-efficacy, marriage, intimacy, and health. The negative effects on life quality are stronger for wives than for husbands. The model suggests that the life quality of couples with fertility problems could be improved if health care providers and couples themselves took steps to reduce such stresses and/or reduce their impact on the marriage factors.