title: Levels and associations among self-esteem, fertility distress, coping, and reaction to potentially being a genetic carrier in women with diminished ovarian reserve.
abstract: OBJECTIVE
  To measure the level of distress and its relationship with other psychologic factors in women with diminished ovarian reserve (DOR) who participated in a fragile X genetics study.
  
  
  METHODS
  Longitudinal data analyzed with structural equation modeling.
  
  
  METHODS
  Four U.S. private and academic fertility centers.
  
  
  METHODS
  Sixty-two infertile patients with DOR.
  
  
  METHODS
  None.
  
  
  METHODS
  Fertility Problem Inventory, Coping Scale for Infertile Couples, Rosenberg Self-Esteem, Health Orientation Scale.
  
  
  RESULTS
  Nineteen percent had low fertility distress, 56% had average fertility distress, and 24% had high fertility distress. Thirty-six percent self-reported a "favorable" or "very favorable" emotional response to potentially being a fragile X carrier (termed "emotions"), 53% were "ambivalent," and 11% had an unfavorable reaction. Three months after learning that they were not a carrier, these percentages were 91%, 9%, and 0%, respectively. Emotions at this second time point were significantly more positive than at pretesting. At baseline, higher self-esteem was a significant predictor of reduced fertility distress both directly and indirectly through emotions. Fertility distress was not associated with coping. Self-esteem, fertility distress, pretesting emotions, and coping were unrelated to posttesting emotions.
  
  
  CONCLUSIONS
  The potential of having an explanation for one's DOR condition may have a beneficial impact on women's psychologic states during the process of genetic testing, and this appeared to be especially true for women with higher self-esteem. Psychologic interventions targeted to women with low self-esteem may reduce distress and improve reactions to genetic testing.
authors.affiliation: Department of Psychology, Stony Brook University, Stony Brook, New York, USA.
authors.forename: Ceylan
authors.initials: C
authors.lastname: Cizmeli
authors.forename: Marci
authors.initials: M
authors.lastname: Lobel
authors.forename: Jason
authors.initials: J
authors.lastname: Franasiak
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Pastore
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D017281:Cost of Illness; D004644:Emotions; D005260:Female; D005298:Fertility / Q000235:genetics*; D005600:Fragile X Syndrome / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology / Q000523:psychology*; D006580:Genetic Carrier Screening; D005817:Genetic Counseling; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000379:methods; D006579:Heterozygote; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology / Q000523:psychology*; D008137:Longitudinal Studies; D010641:Phenotype; D016649:Primary Ovarian Insufficiency / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology / Q000523:psychology*; D011594:Psychometrics; D012649:Self Concept; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States