Background: Infertility is associated with substantial psychological and spiritual distress. In pronatalist societies, women with primary infertility—even when attributable to male-factor causes—often experience disproportionate stigma and emotional burden. Spiritual well-being (SWB) represents an important coping resource in this context. This study aimed to assess SWB and identify its socio-demographic, clinical, and interpersonal determinants among women with primary infertility due to male-factor etiology.

Methods: This descriptive cross-sectional study was conducted from 2024-2025 at two tertiary infertility centers in Kerman, Iran. Using proportionate stratified sampling, 150 women with confirmed male-factor primary infertility who were candidates for intrauterine insemination (IUI) were recruited. Data were collected using a structured clinical questionnaire and the Paloutzian and Ellison Spiritual Well-Being Scale (score range: 20–120). Statistical analyses included bivariate tests and multiple linear regression.

Results: The mean age of participants was 31.36±5.12 years, and the mean duration of infertility was 4.78±3.37 years. Mean scores for existential well-being (35.29±3.86), religious well-being (28.01±3.22), and overall SWB (96.58±17.53) indicated moderate levels of spiritual well-being. Higher educational attainment was significantly associated with greater existential and overall SWB. Stronger self-reported religious adherence predicted higher overall SWB. Additionally, stable family relationships and strong perceived family support during times of difficulty were positively associated with all dimensions of SWB. Among clinical variables, the number of IUI attempts was significantly associated with both religious and overall SWB.

Conclusion: Women experiencing primary infertility due to male-factor causes demonstrate moderate levels of spiritual well-being, influenced by educational, religious, familial, and treatment-related factors. Integrating holistic, family-centered, and culturally sensitive spiritual care into infertility services may help reduce psychosocial burden and improve patient well-being.