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Fertility Treatment Response: Is It Better to Be More Optimistic or Less Pessimistic?

Bleil, Maria E. PhD; Pasch, Lauri A. PhD; Gregorich, Steven E. PhD; Millstein, Susan G. PhD; Katz, Patricia P. PhD; Adler, Nancy E. PhDInfertility Outcomes Program Project Group

doi: 10.1097/PSY.0b013e318242096b
Original Articles

Objective To evaluate the prospective relation between dispositional traits of optimism and pessimism and in vitro fertilization (IVF) treatment failure among women seeking medical intervention for infertility.

Methods Among 198 women (aged 24–45 years, mean [standard deviation] = 35.1 [4.1] years; white, 77%), the outcome of each participant’s first IVF treatment cycle was examined. Treatment outcome was classified as being successful (versus failed) if the woman either delivered a baby or was pregnant because of the cycle by the end of the 18-month study period. At baseline, optimism and pessimism were measured as a single bipolar dimension and as separate unipolar dimensions according to the Life Orientation Test total score and the optimism and pessimism subscale scores, respectively.

Results Optimism/pessimism, measured as a single bipolar dimension, predicted IVF treatment failure initially (B = −0.09, p = .02, odds ratio [OR] = 0.917, 95% confidence interval [CI] = 0.851–0.988), but this association attenuated after statistical control for trait negative affect (B = −0.06, p = .13, OR = 0.938, 95% CI = 0.863–1.020). When examined as separate unipolar dimensions, pessimism (B = 0.14, p = .04, OR = 1.146, 95% CI = 1.008–1.303), not optimism (B = −0.09, p = .12, OR = 0.912, 95% CI = 0.813–1.023), predicted IVF treatment failure independently of risk factors for poor IVF treatment response and trait negative affect.

Conclusions Being pessimistic may be a risk factor for IVF treatment failure. Future research should attempt to delineate the biological and behavioral mechanisms by which pessimism may negatively affect treatment outcomes.

From the Departments of Psychiatry (M.E.B., L.A.P., N.E.A.), Medicine (S.E.G., P.P.K.), and Pediatrics (S.G.M.), University of California San Francisco, San Francisco, California.

Address correspondence and reprint requests to Maria E. Bleil, PhD, University of California San Francisco, 3333 California Street, Suite 465, San Francisco, CA 94143-0848. E-mail:

Preparation of this article and the research described here were supported bythe National Institute of Child Health and Human Development (P01HD037074), the National Institute of Mental Health (T32MH019391), andthe National Institute on Aging (K08AG03575).

The authors have no conflict of interest to declare.

Received for publication September 21, 2010; revision received October 16, 2011.

Copyright © 2012 by American Psychosomatic Society
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