The understanding of psychiatric morbidity in the infertile population relies to a great extent upon the instruments used to measure psychopathology. The present study investigated the distinction between psychiatric morbidity and infertility strain reactions in a sample of 104 infertile couples using the SCL-90-R. Some symptoms ordinarily indicative of psychopathology can represent normal side effects or reactions to infertility treatment, thus causing spurious estimates of pathology. Alternately, item analyses revealed a profile of infertility strain reflecting tension, depressive symptoms, worry, and interpersonal alienation frequently occurring among both male and female infertility patients. The concept of infertility strain is suggested as a vehicle for understanding the functioning of infertile patients and to circumvent the stigmatizing effects of psychiatric labels while providing appropriate intervention.