A self-determination theory perspective on well-being and sense of identity in women with and without fertility difficulties

Fertility difficulties represent a significant stressor for many women, yet theoretical models explaining how psychological factors jointly contribute to well-being in this context remain limited. Drawing on Self-Determination Theory (SDT), this study tested a model linking perceived social support, basic psychological need satisfaction and frustration, identity synthesis and confusion, and subjective well-being in two groups: women experiencing fertility difficulties (N = 205) and women without such difficulties (N = 222). SDT posits that the mechanisms through which proximal social contexts promote well-being via basic psychological needs are universal. Accordingly, we examined whether the hypothesized mediation model would demonstrate structural invariance across groups. Results showed that the pattern of observed associations among study variables was invariant across women with and without fertility difficulties. Perceived social support was positively related to need satisfaction and negatively related to need frustration; need-based experiences, in turn, predicted identity synthesis and confusion, which were associated with higher and lower well-being, respectively. These findings support the SDT-based proposition that the processes linking supportive proximal social contexts to well-being operate similarly across individuals, including those experiencing different fertility-related circumstances. Beyond theoretical implications, the findings highlight the potential for developing psychological interventions informed by SDT principles. Programs that promote autonomy-supportive communication, competence-building, relatedness-enhancing interactions, and identity coherence may benefit all women, including those navigating fertility challenges. Integrating such support within fertility clinics and community-based services may represent an important step toward more holistic reproductive care.