Defense Date


Document Type


Degree Name

Doctor of Philosophy



First Advisor

Kathleen M. Ingram, J.D., Ph.D.



Title: The Ticking of the “Biological Clock”: Worry about Future Fertility in Nulliparous Women

By: Karen Kersting, M.A., M.S.

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University.

Virginia Commonwealth University, 2013.

Major Director: Kathleen M. Ingram, J.D., Ph.D.

Associate Professor of Psychology

Department of Psychology

Modern women are waiting until later in their lives to have children than women of previous generations, a trend influenced by a number of factors including financial stability, dating norms, and career goals and responsibilities. As women age, their fertility may decline in ways that make it less likely that they will be able to become pregnant and increase the odds having a child born with a birth defect. Some women are known to experience worry about whether they will be able to become pregnant when they are ready to try. The primary purpose of this study was to assess how much women are worrying, what demographic and cultural factors predict higher levels of worry, and if worry about future fertility is related to symptoms of distress. Through online recruitment, 598 nulliparous women between the ages of 25 and 40 years completed a cross-sectional, self-report survey. Mean scores on measures of future fertility worry revealed a low-to-moderate, but consistently present level of worry. As hypothesized, multiple regression analysis showed that higher levels of endorsement of the personal importance of motherhood were related to higher levels of future fertility worry, as was age and the interaction of age and importance, but to a lesser extent. Knowledge of fertility was not related to increased worry. Additionally, higher levels of future fertility worry were shown to be related to higher levels of symptoms of depression and symptoms of anxiety. And an open-ended question revealed that women hold a variety of reasons for not wanting to become pregnant presently, including career, relationship, and financial concerns. Overall, the study contributes rigorous findings to a previously unstudied research question and population: How much do nulliparous women who have not experienced infertility worry about their fertility? And what influences that worry? The findings imply that media, researchers, practitioners, the general public, and even women themselves may have held errant assumptions about the thoughts and feelings of nulliparous women, and that worry about fertility is complex, generally moderate, and closely related to personal values.


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