Psychological and emotional concomitants of infertility diagnosis in women with diminished ovarian reserve or anatomical cause of infertility

Women with diminished ovarian reserve had greater in- fertility distress than women with anatomical cause of in- fertility. For both, self-esteem was associated with lower distress, which predicted positive reactions to diagnosis.

Volume 108, Issue 1, Pages 161–167


Jennifer M. Nicoloro-SantaBarbara, M.A., Marci Lobel, Ph.D., Silvina Bocca, M.D., Ph.D., James R. Stelling, M.D., Lisa M. Pastore, Ph.D.



To examine the magnitude and predictors of emotional reactions to an infertility diagnosis in two groups of women: those with diminished ovarian reserve (DOR), and those clinically diagnosed with an anatomical cause of infertility (ACI).


Cross-sectional study.


Academic and private fertility clinics.


Women diagnosed with DOR (n = 51) and women diagnosed with ACI (n = 51).


Not applicable.

Main Outcome Measure(s)

Fertility Problem Inventory (infertility distress), Rosenberg Self-Esteem Scale, Health Orientation Scale (emotional reactions to receiving a diagnosis).


Women with DOR had statistically significantly higher infertility distress scores than women with ACI and higher scores on subscales assessing distress from social concerns, sexual concerns, and a need for parenthood. In both groups, higher self-esteem was associated with lower infertility distress. Hierarchical multiple regression analyses revealed that for women with DOR and those with ACI lower infertility distress but not self-esteem predicted a more positive emotional reaction toward receiving a fertility diagnosis.


Women diagnosed with DOR have greater infertility distress but similar self-esteem and emotional reactions to their diagnosis compared with women who have an anatomical cause of infertility. These results suggest that for both groups distress surrounding infertility itself may influence the way women respond to learning the cause of their infertility.

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