Objective To analyze the impact of psychological resilience in women during early pregnancy after assisted reproductive technology (ART) on the mediating role of pregnancy stress and sleep quality.Methods Convenience sampling was used to select early pregnant women who successfully underwent ART in our hospital gynecology from March 2023 to April 2024 as the research subjects. General information survey, psychological resilience scale, Pittsburgh Sleep Quality Index, and Pregnancy Stress Scale were used for questionnaire survey. Multiple linear regression was used to analyze the influencing factors of sleep quality in early pregnancy women after ART. Pearson correlation was used to analyze the relationship between psychological resilience, pregnancy stress, and sleep quality in early pregnancy women after ART, and Amos Graphics software was used to establish a structural equation model for analysis. Results The psychological resilience score of 203 women in early pregnancy after ART surgery was (55.82±12.64) points, which was at a moderate to low level; The sleep quality score is (7.64±1.78) points, indicating poor sleep. The pregnancy stress score is (44.53±9.26) points. There is moderate pregnancy pressure in women in early pregnancy after ART surgery. The results of multiple linear regression analysis showed that monthly household income, duration of infertility, and pregnancy related symptoms were the influencing factors of sleep quality in early pregnancy women after ART, accounting for 51.7% of the total variation. The total score of psychological resilience in early pregnancy women after ART was negatively correlated with the sleep quality score (r=-0.219, P<0.05), and also negatively correlated with the total score of pregnancy stress (r=-0.305,P<0.001), while the sleep quality score was positively correlated with the total score of pregnancy stress (r=0.342,P<0.001). The parameters were evaluated using the maximum likelihood method, with a chi square/df of 2.719, RMSEA of 0.072, AGFI of 0.914, NFI of 0.949, GFI of 0.962, IFI of 0.971, and CFI of 0.958, indicating a good model fit. Psychological resilience could negatively predict pregnancy stress, with a standardized path coefficient of -0.401(P<0.001). Psychological resilience could negatively predict sleep quality, with a standardized path coefficient of -0.529 (P<0.001). Pregnancy stress could positively predict sleep quality, with a standardized path coefficient of 0.397 (P<0.001). Psychological resilience played an indirect predictive role in pregnancy stress and sleep quality, with a standardized path coefficient of 0.212. The total effect value of pregnancy stress on sleep quality was 0.609, and the mediating effect was 34.81%.Conclusion Psychological resilience can negatively predict pregnancy stress and sleep quality, playing a partial mediating role between pregnancy stress and sleep quality