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Psychosom Med. 2012 Feb-Mar;74(2):193-9. doi: 10.1097/PSY.0b013e318242096b. Epub 2012 Jan 27.

Fertility treatment response: is it better to be more optimistic or less pessimistic?

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Department of Psychiatry, University of California San Francisco, 3333 California Street, Suite 465, San Francisco, CA 94143-0848, USA.



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.


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.


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.


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.

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