What to Say: Infertility
The causes and effects of infertility may be more complex than you imagined.
The causes and effects of infertility may be more complex than you imagined.
Renee Harleston
Reviewer URLThe causes and effects of infertility may be more complex than you imagined.
What we'll cover
Infertility can be heartbreaking, even as one seeks treatment to overcome it. Show compassion by acknowledging a friend or loved one’s struggles, and make an intention to connect.
In this “What to Say” guide, we break down what may cause infertility, explain different treatments for infertility and their side effects and offer suggestions for what to say and not say when discussing it with a loved one.
What it is
According to a report from UCLA Health, an estimated 15% of couples have trouble conceiving after 12 months of trying. In 40-50% of cases, impaired sperm function is a contributing factor to infertility in couples; in 15-20% of cases, it is the sole factor. Other possible causes of infertility may include advanced maternal age, uterine fibroids, endometrial polyps and endometriosis, among others.
How to treat it
Many different medications and treatments are used for infertility. Some treatments are created with the goal of creating optimal conditions in the fallopian tubes and uterus (such as removing blockages, fibroids or polyps) and/or regulating or stimulating the production of eggs.
Other forms of infertility treatment may include, but are not limited to, in vitro fertilization (IVF) and intrauterine insemination (IUI). With IVF, an egg is implanted with sperm in a lab to create embryos, which are then implanted in the uterus. IUI involves inserting specially selected sperm directly into a uterus and closer to one’s tubes and ovulated egg. Each of these options are often paired with medication to stimulate egg production.
For those under the age of 35, the odds of having a full-term, healthy birth weight live birth is 21.3% per IVF cycle, according to a 2015 report from the U.S. Society of Assisted Reproductive Technology (SART). For those ages 35-37, the chance drops to 17%, and for those ages 38-40 years old, they have a 11.1% chance. The odds continue to drop as one gets older.
Side effects
Side effects from infertility medicine include nausea, headaches, cramps and mental health issues like depression and anxiety. Certain drugs are administered via injection, which could also result in tenderness and bruising at the injection site. Some may experience a more serious side effect from hormonal treatments, called ovarian hyperstimulation syndrome (OHSS), which can lead to swollen, painful ovaries.
In addition, there’s an emotional toll as well—not only from the experience of going through infertility but also from the high levels of hormones in most fertility treatments.
What not to say
Every person’s fertility journey is different. And although one may enter a conversation with good intentions, making assumptions or offering advice when it was not requested only hurts a person facing infertility. That is not being a good listener. That is just responding. Take time to let the other person lead the conversation and take your conversational cues from what they share, not what you think is best.
"You should try my acupuncturist."
Why it doesn't work: Sometimes, refraining from giving any kind of advice (even something like, “Maybe you should take a break from trying for a while”) is the best course of action. These well-meaning suggestions imply that you know the magic formula for getting pregnant when you don’t.
"I’ll bring little Toby over to cheer you up."
Why it doesn't work: It might be extremely difficult for someone going through fertility issues to be around babies, children or people who are pregnant. Follow their cues. If they ask about your kids or suggest a get-together, great. If not, don’t dwell on the subject.
"It’s been a while since it happened. You should move on."
Why it doesn't work: Everyone grieves differently, and their grief may linger. You may want to see your loved one feel better quickly, but telling them they should just get over it and move on doesn’t really work. It may even make them feel ashamed or invalidated.
"Have you thought about adoption?"
Why it doesn't work: Don’t make assumptions. For their own personal reasons, having a genetically related baby is their first choice. Respect that, rather than bring up other options that they are already aware of and may not currently want.
"This isn’t worth the stress you’re going through."
Why it doesn't work: It’s not your calculation to make. The decision to have a child by whatever means necessary is a personal one. No outsider—no matter how well-meaning or close to the potential parent/s—can evaluate how “worth it” this is.
"Are you going to try IVF?"
Why it doesn't work: There are many different ways of treating infertility—and you can be sure a person has considered all of them, with help from their doctor. If they want to share the details with you, they will. But don’t ask.
Nothing.
Why it doesn't work: Finding the right words can be difficult for anyone, but that doesn't mean you should neglect to say anything to your friend or loved one. During especially difficult situations, your loved one will appreciate any kind or reflective words you can offer during their time of need. Saying something—with intention and thoughtfulness—is better than saying nothing.
Instead of avoiding a conversation in a fraught moment, try a phrase like, "I can't begin to know what you are going through, but I am here for you." If the moment is more lighthearted or celebratory, a simple, "I am so happy for you right now!" goes a long way.
What to say
Now that you understand what causes infertility and how one may choose to treat it, we’ll break down a few conversation starters to support your friend or loved one.
Note: These conversation starters are just suggestions. Each individual’s experience will vary and users should measure their words based on what they know and do not know about their loved one.
"This must be hard. How are you doing?"
Why it works: By acknowledging what they’re going through, you are letting your friend or loved one know that you care—and are thinking about—them. When and if they respond, make sure to follow their conversational cues. They may detail their latest round of IVF, or they may just say, “Fine, thanks.” Both responses are OK. And so long as you did not say something that may hurt them, their response is not about you.
"I’m always here if you want to talk."
Why it works: Not everyone is ready to talk when you are. By leaving the door open for future conversation, you are letting them know that you’re an empathetic ear for whatever good or bad news they feel like sharing.
How to recover
Saying the right thing to a friend or loved one facing infertility, especially if you have not faced infertility yourself, can be difficult. Recover from any conversational blunders by first apologizing for your mistake. Take time to understand why insensitivity, a lack of empathy or a disregard for understanding may have led to this moment. Be intentional about what you say, and how you say it, moving forward.
Other suggestions
Sometimes, the best thing to say is to say nothing at all. Participating in activities or providing care packages can be welcome solutions that offer support without dwelling in conversation about heavy subject matter.
Invite them to do something fun.
How this helps: Whether it’s a glassblowing class, aerial yoga, hatchet throwing or an online book group discussion, any activity that you can enjoy together will be a welcome temporary distraction from their fertility issues. Experiences like infertility can be all-consuming and it can be a relief to focus on something else for a while.
Put together an infertility treatment care package.
How this helps: Fill it with things like a heating pad (for sore injection sites), a gift card to a spa or beauty treatment, and a good book or two for doctor waiting room downtime.