How can foods, supplements etc. help you to optimize your quality? 

Carolina Kaufman, naturopathic nutritional therapist and owner of Sprouted Health responds to our questions. 

How can foods, supplements etc. help you to optimize fertility?

Instagram Live - egg and sperm quality with nutritionist Carolina Kaufmann

Maya Maria Brown, M.A., is an infertility mental health expert. She has a master’s in Counseling Psychology, and has worked with individuals and couples on infertility and relationships. She also has personal experience with infertility and is currently in treatment.

Many people with infertility also experience anxiety - find out why, and how to cope.

Anxiety is the most common mental illness in the world. Around 30% of adults experience anxiety during their lifetime.

Anxiety can be experienced in response to certain life experiences or circumstances, like during infertility, surrounding abuse, or after the loss of a loved one. But anxiety isn’t always related to an external stimulus. Generalized anxiety disorder, the most common form of anxiety, is the experience of anxiety in daily life without a specific or known cause.

According to the NIMH, “Anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. The symptoms can interfere with daily activities such as job performance, school work, and relationships.”

Here are a few examples of what anxiety can feel like:

“Chronic anxiety is messy and unpredictable, overpowering and insidious, physical and mental, and at times so unexpectedly debilitating I’m unable to speak or think clearly or even move.” - Steve Barry

Anxiety is like when you’re playing a video game, and the evil boss’ music is playing so you know danger is nearby, but no threats actually appear.

“Living with anxiety - living alarmed - makes it impossible to enter the moment, to land inside my body and be there. I cannot be in the moment because I am too afraid of what the next moment will bring. I have to be ready.” - Glennon Doyle

Anxiety is like a revolving door of negative thoughts in your brain that never stops spinning, no matter how much you try to reassure yourself that everything is okay.

How to know if you’re experiencing anxiety

Anxiety can impact us physically and mentally. Sometimes the experience is so glaring and powerful that we can’t feel or think about anything else. But other times, anxiety can be sneaky, and we might not even realize we’re anxious until someone else points out to us that we’re experiencing symptoms like shaking, sweating or talking nonstop.

In order to cope with anxiety, we first need to be able to recognize it when you’re experiencing it.

Difficulty concentrating - mind going blank

Rumination, thinking about something negative over and over again

Sleep problems, e.g. difficulty falling or staying asleep, restlessness, or unsatisfying sleep

Depersonalization, dissociation or disconnected from self

One way to recognize if you’re experiencing anxiety is to do a body scan meditation. Put away distractions and focus on your breath as you breathe deeply into your belly. Bring your awareness to each part of your body, starting with your toes and ending with your head, and notice any sensations you feel.

If you’re experiencing anxiety, you might notice some physical symptoms or thoughts that are triggered by practicing mindfulness in this way.

Many people with infertility experience anxiety. Numerous studies show that “women with infertility report elevated levels of anxiety and depression.” Research suggests that up to 60% of infertile individuals report symptoms of anxiety and depression, and that their levels of anxiety and depression are significantly higher than in fertile controls.

One study on infertility and anxiety showed that “The prevalence of anxiety among the infertile group was higher compared with patients diagnosed with HIV-positive, cancer, heart diseases, or other serious, life-threatening chronic diseases.”

This means two things: first, that it’s common to experience anxiety when facing infertility and that you’re not alone. Second, that because people with infertility are at a higher risk for anxiety, it’s important to be mindful of your mental health and seek support.

When it comes to the causes of anxiety during infertility, there could be numerous factors:

One study found that 86.8% of the women with infertility surveyed were experiencing anxiety, and it was correlated to how long they had been experiencing infertility.

Fertility medications, like Lupron and Clomid, can have anxiety symptoms as side effects.

The stress of managing doctor’s appointments, tracking cycles and ovulation, taking medications, and timing intercourse can cause anxiety.

The life circumstances surrounding infertility, such as other people in your life conceiving easily, and the uncertainty of your future, can be anxiety-inducing.

6 tips for coping with anxiety related to infertility

Anxiety can be a debilitating mental health issue, so seeking support is crucial for your well-being. A mental health professional can provide the interventions needed to help you cope with your anxiety.

You don’t have to experience severe anxiety symptoms to reach out for help - even if you don’t think you’re experiencing anxiety, having mental health support during infertility can be immensely helpful.

Know that you’re not alone - reach out to others

As we’ve seen, it’s very common for people with infertility to experience anxiety. Talk to the people you know who understand infertility - people in your life, or in online forums like the Tilly community - to help you feel connected and less alone.

Social connection is an important part of our overall well-being, so reach out to people you love and trust to help you as you go through this difficult time.

Taking some moments to focus on your breath and return to the here and now can help calm anxious thoughts. If your anxiety is too high to allow you to sit still and be present in your body, you can also practice mindfulness while you go for a walk in nature, dance it out in your living room, or do something active like swimming.

Mindfulness is about learning to observe your thoughts without judgment. You don’t have to be perfectly zen or blank, you’re just noticing what’s going on in yourself, which is a great tool for managing anxiety.

Focus on something positive, creative or exciting

Focusing on something productive or engaging can help calm your anxiety. Try starting a new hobby, or returning to something you used to love doing. It can be something creative or intellectually stimulating, like knitting, watercolors, puzzles, or a musical instrument.

Not only will this help you focus on something other than anxiety, it can also be fun and support your well-being in general.

Cognitive restructuring, or finding new ways of thinking, can help you cope with anxiety. Tools like Cognitive Behavioral Therapy, loving kindness meditation, and positive affirmations can help you notice and change negative thought patterns.

When you find yourself stuck in an anxiety-induced negative thought spiral, try questioning your assumptions, finding alternative thoughts, or gathering evidence against the negative thoughts to help your mind break out of the cycle.

Remember that so many people with infertility experience anxiety. This isn’t a personal shortcoming, and there’s nothing wrong with you. Being kind to yourself is crucial for your ability to care for yourself and heal from this experience.

Give yourself treats throughout the day - this could be literal treats like chocolate, or symbolic treats like five minutes alone, an extra long bath, listening to your favorite song, or hugging someone you love. You deserve love, care and support.

Many people with infertility also experience anxiety - find out why, and how to cope

What are our options to have a child if we don’t have eggs, sperm and a uterus readily available?

When you and your partner or partners want to have a child, the path might not be straightforward if you don’t have eggs, sperm and a uterus readily available in your relationship.

Let’s look at what might be challenging and beautiful about growing your family as an LGBTQ+ couple or relationship, and what support can be helpful throughout the process.

“Social infertility” is a term that describes people who would like to have a baby, but face challenges due to their physiology and relationship. Basically, the relationship does not include the physiology needed to conceive and develop a pregnancy through to a live birth.

People who experience social infertility include two women in a relationship; two men in a relationship; and people in relationships in which one or both people are trans and do not have the reproductive physiology to create a child with sperm, egg and uterus.

Also relevant to this topic are people who are in a polyamorous relationship; even if there are eggs, sperm and a uterus present, it might not be obvious or simple to determine who will play which part in creating a child.

7 challenges that LGBTQ+ people might face when trying to have a baby

It’s important for all people to be aware of the challenges that people in an LGBTQ+ couple or relationship face when trying to have a baby.

Understanding the challenges can help the people themselves be more prepared, and can help those supporting them be able to show up for them in the ways that they need. There are also laws and policies that need to be changed, so the more people understand these challenges, the better chance we have at changing the rules so LGBTQ+ people can grow their families more easily.

Here are some of the challenges that LGBTQ+ people might face when trying to have a baby.

The often overwhelming costs associated with assisted reproductive technology are not unique to LGBTQ+ people, but unlike couples with a man and a woman, LGBTQ+ people are almost guaranteed to incur costs when trying to have a baby.

When all that is needed is sperm (for example, when two women are trying to have a child together), the costs could be kept low by using a known sperm donor and doing an at-home insemination - but that’s not always an option. And if no one in the relationship has eggs and/or a uterus, the costs of using an egg donor and/or surrogate can be incredibly high.

Some health insurance policies will only cover assisted reproductive technology for heterosexual couples. So, LGBTQ+ people might be blocked from health insurance coverage that heterosexual couples are able to receive.

Some medical professionals and fertility clinics require that a couple tries to get pregnant for one year before they are able to seek treatment. But if LGBTQ+ people in a relationship are not physically able to conceive unassisted, that time limit is simply wasted time.

Some clinics/countries do not offer double donation

Some people have someone in the relationship who has a uterus, but both donated sperm and donated eggs are needed to create an embryo to implant into the person with a uterus. While many clinics will work with donated eggs or donated sperm, some have limits where the other element (either the egg or the sperm) must come from someone in the relationship. This could be due to the clinic’s policies, or the laws of the country the clinic is in.

Some clinics/countries don’t work with LGBTQ+ people at all

Unfortunately, there are places in the world where the process to have a child as an LGBTQ+ couple or relationship is not possible. It might be in the country’s laws or the clinic’s policy that assisted reproductive technology is only available to men and women who are trying to conceive and have an infertility diagnosis. Adoption is also not available to LGBTQ+ people in some places.

Being misgendered by clinics and medical professionals

Many medical staff are not trained in inclusive language and practices. Trans and genderqueer people are frequently misgendered by the medical field, and this can be harmful and painful when it comes to fertility treatments.

For example, a medical professional might want to consider the options available to a couple in which one or both people are trans. It’s important that the people in the couple are spoken to using the pronouns and genders they identify as, while sensitively and respectfully discussing the possibilities available due to their ASAB (assigned sex at birth). Unfortunately these conversations are often approached without care or regard to a person’s identity.

Many states and countries have laws around parenthood that can pose challenges to LGBTQ+ people. In some places, a child’s birth certificate only has space for a mother and a father, and it must be the genetic parents’ names written on the birth certificate.

An example scenario is if two men are using an egg donor, one of the men’s sperm, and a surrogate to have a child. In some places, the man whose sperm is not used must legally adopt the child, rather than being the parent on the birth certificate and considered a father from the time of the child’s birth. The process of adopting your own child can be logically and psychologically challenging.

Not being genetically related to your child

Any person who has a child who is not genetically related to them - whether it’s through egg/sperm/embryo donation or adoption - might struggle with the situation. There might be feelings around your partner being genetically related to your child when you’re not, or the decision of whose DNA will be involved might have been a difficult one to make. While heterosexual couples might also face this challenge due to infertility, LGBTQ+ people are almost guaranteed to have this be part of their experience as a couple or relationship.

What can support LGBTQ+ people wanting to have a baby

As we’ve seen, LGBTQ+ people wanting to have a baby can face many challenges. Fortunately, there are many ways they can be supported through the process. Here is a list of things that LGBTQ+ people and the people who care about them can do to have support as they try to have a child.

Consider for yourself what it means to be a parent.

People who will not be genetically related to their child(ren) might have feelings about what it means to be a parent. As we explored in our article about egg donation, it can be helpful to consider what parenting is to you, beyond DNA. Passing on family and cultural traditions, life lessons, and love and support are things that you might consider to be beautiful aspects of parenthood that you can experience with or without a genetic connection.

Find supportive clinics and medical professionals.

It might take a few tries, but there are doctors who are sensitive and have great expertise when it comes to working with LGBTQ+ people. You deserve to work with people who understand your relationship and goals, and will do everything they can to help you have a baby. Hopefully, you won’t have to travel too far to find them, but it can be worth it to take your time to find the right clinic and doctor for you.

When it comes to the barriers to having children that are dictated by laws and policies, there might be things you can do to change them. This tip is especially aimed at people who support LGBTQ+ people having children, since the LGBTQ+ people themselves shouldn’t have to do this fight alone. We can all play a part in calling decision makers, educating clinics and medical professionals, and spreading the word about unfair and discriminatory policies.

Fertility treatments and choices can be overwhelming, and can be a lot to navigate on your own. Try the activity "Building your support network" in the Tilly app to help you, or take some time to consider who in your life can help you in this experience. It can be helpful to talk through difficult decisions with a friend, or have your family cook meals for you when you’re actively in treatment. And if you don’t feel you have people in your life who can show up for you in that way, you can find online support groups filled with people who understand what you’re going through.

Do you have a stressful doctor’s appointment coming up? This is a short meditation that you can do in the waiting room to help you prepare.

Lily Hardy is an accredited Yoga Teacher and certified Breathwork Facilitator that is passionate about empowering others to unlock a life they truly love and desire to wake up to everyday. After struggling with c-PTSD and debilitating anxiety for the majority of her life she discovered through therapy, meditation and breathwork that there was in fact another way to feel safe and content in your own skin.

Youtube video Waiting room meditation - prepare for a stressful appointment

Waiting room meditation - prepare for a stressful appointment

Helping you get the mental health support you need

Infertility can have a huge impact on our lives, including and especially on our mental health. With all the challenges, stressors, grief and decisions that come with infertility, having mental health support is crucial for your well-being.

When it comes to mental health professionals, it’s not one-size-fits-all. Not only are there lots of different approaches to working with you that therapists can use, but there’s also the question of who you feel safe and comfortable with.

It can take some time to find the right therapist for you. Many therapists offer a free phone consultation when you can ask them questions. Others will have you do a trial session to see if it’s a good fit.

These questions can help you figure out what is most important to you when looking for a therapist to help with infertility, and which therapist is the right fit for you.

7 questions to ask a mental health professional

There are all kinds of mental health professionals out there, and the professional associations and licenses can vary state to state, and country to country. Ideally, a therapist will have a background in psychology, and will be licensed in a way that enforces a code of ethics they have to abide by.

There are people who offer mental health support specifically for infertility that don’t have this formal training - it’s up to you if you’re comfortable working with someone who might understand exactly what you’re going through, even if they’re not trained or licensed. Regardless, getting to know their background can help you get a feel for how they work.

Do you have experience working with people going through infertility?

This might not be a requirement for you, but it can help to know if they have at least a baseline understanding of what people experiencing infertility go through. You probably already have to explain the ins and outs of treatment and your experience to the people in your life; it’d be nice to not have to cover the basics before you can dive into your emotional experience when talking with a therapist.

Infertility can already be an incredibly isolating experience, and feeling as though someone really understands what you’re going through can be a much-needed relief. You might want to find a therapist who you know will be able to meet you where you are when it comes to infertility.

How would you approach working with my struggles with infertility?

Some mental health professionals take an action-oriented or goal-oriented approach. This is especially true for coaches, who tend to focus on the future and how you can meet your goals. Cognitive-behavioral therapists tend to work on treating challenges that you’re experiencing day-to-day, with activities and systems to support your work. Therapists who have a psychodynamic or relational approach are more likely to work with you on deeper emotional experiences, with a less structured approach, allowing for a more fluid process.

For many people, infertility is a traumatic experience. It can be considered complex trauma, as the crisis extends over a long period of time and can have many impacts. So, working with a trauma therapist can be especially helpful for people with infertility.

How do you typically work with disenfranchised grief?

Going through infertility can involve feeling a lot of grief. There are so many losses you might experience, including pregnancy loss, the loss of a dream, the loss of the life you thought you’d live, and the loss of the person you once were. The grief surrounding these kinds of losses are sometimes called “disenfranchised grief,” referring to the fact that they’re often not considered losses in the traditional sense. People with infertility tend to have their grief invalidated and misunderstood by those around them.

It can be helpful to have support processing your grief with someone who can recognize these things as losses in need of grieving. Some mental health professionals might have techniques or ideas for working with grief that you really connect with, so it might be helpful to understand how they approach the subject.

Do you collaborate with other therapists?

You might already have a therapist you’ve been working with, and are looking for an additional professional to help you with infertility. In that case, it could be helpful if the two therapists communicated about your case so they could better support you. This would be done with a consent form that you sign, giving permission for the two therapists to discuss your case with one another.

You also might want to work with a couples therapist, if you don’t already. That’s another case where your different therapists sharing notes and insights with each other could benefit you. This of course isn’t a requirement, but can be helpful to think about.

Would you be able to follow certain steps with my clinic?

Some clinics require that you see a mental health professional before moving forward with a specific treatment, like using donated eggs, sperm or embryos. In that case, at some point you might need your therapist to sign a form, or follow a set of questions about your mental health, to meet your clinic’s requirements. It could be a good idea to ask your clinic what would be required so you can be more specific when you ask the therapist if they’re able to do what’s needed.

Do you follow a certain format or timeline?

Some mental health professionals might have specific timelines or techniques that they work with. If they work with health insurance providers, they will usually need to file reports to the insurance company and follow certain protocols. For example, they might have to follow a 10-session plan, or the insurance company might require the therapist to diagnose you with a mental illness (like depression, anxiety or PTSD) in order for the therapist to work with you.

Even without insurance companies, some therapists prefer to follow a plan that might have limited sessions, or work with a goal-based system in which your time together concludes when you reach those goals. Since infertility can be a long journey with many ups and downs, you might want to understand what limitations there would be when working with a certain therapist.

7 questions to ask your new therapist about working with infertility

IVF, also known as In Vitro Fertilisation, is considered one of the most common treatment for infertility, it is a process where an egg is combined with sperm ‘in vitro’, i.e. ‘in glass’ (or today more accurately in a ‘plastic Petri dish’) outside of the body. 

In this article, we are going to have a closer lock at the IVF stages and what do you expect to see if you are undergoing IVF treatment.

There are different protocols when doing IVF and in the so-called “long protocol” a period of down-regulation is needed before starting hormones that stimulate your ovaries to grow follicles (with the “short protocol” you start stimulation right away).

The purpose of down-regulation is to block your hormone production to prevent your body from ovulating on its own (this could be compared to temporary menopause). In this way doctors can better control ovulation and egg maturation during your treatment. 

You will take hormones, normally in the form of nose spray and/or shots. 

When you start down-regulation depends on your cycle. If you have a regular cycle you normally start down-regulation around 7 days before your next period. If you have an irregular cycle or no cycle at all, you might need to take medications to force a menstruation before starting down-regulation.

It normally takes around 2 weeks to down-regulate.

If you have a regular cycle you should get your period after 2 weeks, which indicates that the down-regulation has been successful. Regardless if your period has come by then or not you should be in contact with your clinic after 2 weeks to set a plan for the next step; starting stimulation (if you started bleeding) or come in for an ultrasound and estradiol test (if you didn't).

If you have an irregular period, you will need to visit your clinic to do ultrasounds and take blood tests to measure your estradiol levels to decide when you’re down-regulated. 

Potential side effects and symptoms of down-regulation

Going through down-regulation can be compared to temporarily going through menopause. This means you might get symptoms related to menopause, both physical and emotional, including headaches, migraines, hot flushes, feeling irritable, down, or even depressed. This might be tough, but not dangerous (hang in there trooper!). 

If your symptoms are affecting the quality of your daily life, don’t hesitate to contact your clinic for counseling.

Sometimes down-regulation takes longer than planned. This does not mean the treatment has failed, it’s just a bump in the road and your clinic should help you set a plan. Make sure you get all the answers you need to feel safe and secure.

Taking your shots at the right time is very important. You can use Tilly's app to keep track of medications. 

If your treatment protocol is updated, don’t forget to update this in the app.

If you feel worried about taking the shots

Taking the shots is something many women worry about when going through IVF. Tell the clinic that you are worried and that you want careful instructions on how to take the shots. Don’t hesitate to ask questions and make them show you several times how to do it.

A tip is to film the nurse during the demonstration so you can look at it again at home.

If possible and if that feels more comfortable to you, maybe you can ask your partner or a friend to help you out with the shots.

In this phase, you will inject hormones daily to help your ovaries grow a large number of follicles - follicles that contain your egg cells. You take the shots at the same time everyday, normally in the evening.

In a natural cycle only one follicle (sometimes two) releases an egg at ovulation, but in IVF you want to generate as many mature eggs as possible to increase the chances of success.

During the stimulation phase you do regular ultrasounds to see how your ovaries react to the treatment. Your doctor checks the number of follicles and their size.

Following how your ovaries react to stimulation will help your doctor to decide if your medication protocol is working or if it has to be changed, and also the optimal time for egg retrieval.

The stimulation phase usually lasts about 9-11 days.

You start with hormones that help your follicles grow, usually FSH or hMG. After 5-6 days you add another medicine, called an antagonist, that prevents your ovaries from releasing your eggs. If your body ovulates too early the treatment will fail since the doctors are not able to retrieve the eggs. 

Finally, you will receive a shot with the hormone HCG to trigger eggs to go through the final stage of maturation. The timing of this shot is vital, it needs to be taken 36-38 hours before egg retrieval.

Alternatives and decisions during this phase

Your doctor will decide on a protocol (medication types, doses and duration) based on your AMH-value and ultrasounds - how many follicles you have is used to predict how you will react to stimulation. You can read more about choosing the right protocol here.

How you will react to stimulation medicines can be hard to predict, and sometimes some adjustments need to be done. This is both common and normal. Your doctor will take decisions after each ultrasound based on how few or many follicles are maturing.

When you have 3 or more follicles around a size of 18-20mm it’s time to take the ovulation trigger shot and plan for egg retrieval (which takes place 36-38 hours later). It’s important to take this shot at the exact time your doctor gives you. 

When taking hormones you might experience some side effects like headaches, tiredness, feeling irritable or down, nausea, bloating or tender breasts. How you will react is individual, some get a lot of side effects and some get few or none at all. 

Side effects can be very unpleasant, but it’s normally nothing to worry about - as a woman you’re aware that hormones can affect how you feel and that’s basically what’s happening now (although we’d rather not have to take tons of hormones of course). 

It’s also common to get some bruising from the injections.

Another potential side effect is Ovarian Hyperstimulation Syndrome (OHSS), often just called overstimulation. This is when your ovaries respond “too well” to the hormones. The risk is higher for women with many follicles, for example if you have PCOS. 

You should always tell your clinic if you experience OHSS-symptoms like nausea, bloating, stomach pain or breathing difficulties during stimulation so that they can make adjustments. OHSS can become serious since the ovaries can get dangerously filled with fluid that can leak into your belly and chest area - this is uncommon, but it’s important to identify OHSS early on so it doesn’t go that far. 

If not enough follicles grow, the cycle may be cancelled. Most clinics don’t go through with an egg retrieval if there are less than 3 follicles. This can of course feel devastating, having invested so much time and energy already. It’s important to remember it doesn’t necessarily mean it won't work the next time though. Sometimes it takes a few attempts to find the perfect stimulation protocol that will work for you. Make sure your doctor is giving you all the answers you need to feel safe and secure before giving it another try.

A low egg reserve is the primary thing that can make it harder to succeed with this step of the treatment. 

Taking your shots at the right time is very important, which Tilly's app can help you with. 

During stimulation you should avoid sexual intercourse a week before retrieval of the eggs and the days following the retrieval. This is due to the risk of infection, but also because sometimes eggs that have not been retrieved can find their way out and be fertilised which can lead to multiple pregnancy.

3. Egg retrieval & Sperm sample, Fertilisation & Growing embryos, and the rest of the steps...

Add your treatment in Tilly's app to receive timely inforamtion about each step of the journey - download here.

IVF, also known as In Vitro Fertilisation, is considered one of the most common treatment for infertility. Learn what happens throughout treatment.

What to expect during the different stages of IVF

Whether you know it or not, you probably know someone going through infertility. 1 in 8 couples wanting to have a child face infertility, so it’s more common than you might think.

To help you be a supportive friend to someone with infertility, let’s take a look at what infertility is, and then dive into how you can help.

Infertility is a medical diagnosis given to anyone who is not able to become pregnant or carry a pregnancy to term after one year of having unprotected sex (in the case of a man and woman trying together). It’s common for it to take a few months of trying to be successful. But as time passes with no pregnancy, the likelihood that there are physical issues that require medical interventions increases. 

The underlying causes of infertility can differ greatly from one person or couple to another, and there is therefore a wide variety of treatments. Many people think that infertility is always age-related. While fertility does decline with age for both men and women, that doesn’t mean that every woman above 35 will struggle to conceive. There are actually a number of infertility causes that have nothing to do with age. 

For people who do not have eggs and sperm - same-sex couples, for example - their experience can be described as “social infertility,” meaning they will need to go through reproductive interventions or adoption in order to have a child.

After one year of trying to conceive (or six months if the woman is older than 35), the couple can visit a doctor (often a Reproductive Endocrinologist) to begin treatment. They will start by doing some tests to get an initial picture of each person’s fertility. Based on the test results and other factors, a treatment plan can be put in place. The approach can vary greatly from person to person; even the specifics of the same treatment, like doses and timing, can be different for different people.

What are examples of fertility treatments?

Lifestyle changes that aim to correct hormonal imbalances or improve sperm quality

A range of add-on treatments like testing embryos, and medications like blood-thinners or immunosuppressants

Each treatment option can involve a large financial commitment, and usually has a major physical toll. And there are no guarantees that any of the treatments will result in a successful pregnancy.

The physical side effects and stress of infertility treatment are a major part of why infertility can be challenging. But that’s not the whole picture. People with infertility are likely facing many struggles emotionally and socially as well. Whether someone is going through treatment, or they don’t have the option or desire to do treatment and instead keep trying on their own, infertility affects many aspects of a person’s life.

How friends can be helpful when going through infertility

Whenever someone is going through a difficult time in life, having friends who can be supportive is crucial. It’s common for someone in a crisis to isolate themselves because social interactions feel daunting, or they feel that no one understands. This can cause the person even more emotional distress, as we need meaningful social interactions to maintain our mental well-being. 

Infertility is a uniquely challenging experience, but the emotional impact is not well-known or talked about due to the stigma surrounding it. It can affect someone in a similar way to when a person has cancer (research shows that infertility patients have the same emotional distress levels as cancer patients), or loses a close relative (infertility can involve a lot of grief).

But many people with infertility don’t receive the same type of sympathy or support from their communities, or society as a whole. They may even struggle with accepting their own feelings, blaming themselves for having a hard time.

Not having your pain acknowledged can deepen the trauma of a difficult experience. This is where the people in your life can make a big difference. 

Each person’s experience is unique, and how they feel might change from day to day. It’s important to take the time to learn what your friend is going through and what they need. But we can explore some common scenarios and experiences to help give you a head start when it comes to supporting your friend.

Society tends to view infertility like this: Someone wants a baby, but they aren’t able to have one, so they’re sad. Then they go to a doctor and take some medications, and it might be taxing, but once they have their baby, everything is better.

But if you look below the surface, infertility is much more than that. Having children is something that many people plan - consciously or unconsciously - for many years, and it’s a highly celebrated and emphasized life experience in society. So when you’re not able to have this experience that you desperately want, and your future becomes uncertain, it can shake someone’s life and identity to the core.

The research is clear: the psychological impacts of infertility are diverse and profound. A person’s physical health, mental health, relationships and daily life are all affected. Many people facing infertility can be clinically diagnosed with anxiety and/or depression.

Some of the other challenging emotions and experiences someone with infertility may struggle with are:

Feeling excluded, as others have children and they’re not “part of the club”

Feeling stuck, like your life is on pause; it can be hard to make any plans

Deep sadness and grief - for both life before infertility, and the life they wish they were living

Relationship challenges, with their partner and the other people in their life

You are not responsible for their well-being

It’s important to know that to be a supportive friend, you do not need to take on the responsibility for their overall well-being. You are not meant to be your friend’s therapist or entire support system.

Also, regardless of what you do, they will most likely have a hard time. No one can take the difficult emotions away entirely - you can simply be there to help them carry the struggle and feel less alone. 

8 ways you can show support to a friend going through infertility

1. Check in with them - with sensitivity 

When someone we know is struggling, we often wait for them to ask for support, not wanting to intrude or “remind them” of their challenges. In reality, when someone is going through something tough, they may not have the energy to ask for help, or know how to reach out in the first place.

We’ve asked our community, and a majority of those facing infertility prefer when people around them ask how they’re doing. Most feel that silence is always worse than saying something, even if you don’t know the “right” thing to say.

One way to be sensitive is to begin with: “It’s completely fine if you don’t want to talk about this, I just want you to know I’m here.” 

You can remind yourself that even if your friend doesn’t want to talk about it with you, at that specific time or ever, showing that you care and validating their emotions can still be really helpful.

Ask how they’re doing, instead of how’s it going

It is most likely more helpful to ask about how someone is feeling rather than only focusing on practicalities like “Did the treatment work?” or “When is your next doctor’s appointment?” Sometimes, all they’ve been doing is thinking about the practicalities, and no one has stopped to talk to them about how they feel.

Infertility can span over years with many ups and downs and long periods of just waiting. Even if your friend stops talking about it, it’s not over, and they might still be deep in the experience. Understanding that and simply sending an “I’m thinking of you” text now and then can really make a difference.

You don’t have to ask about it all the time, but bringing up the subject yourself can take the pressure off of your friend to do so. 

Some friends might not tell you about their infertility in the first place. This can be difficult from a friend’s perspective, because we have to respect their needs and boundaries.

If you are wanting to check in with someone whom you think is struggling with infertility, bringing up the subject gently is important. Make it about checking in with them, rather than your own nosy curiosity.

You can try asking something like, “I know trying to get pregnant can be difficult for some people, and I wanted to check in to see how you’re doing.” You can add something like, “We don’t have to talk about it if you don’t want to, I just want you to know that I’m thinking of you,” to help them feel that it’s their choice to talk about it or not.

Unfortunately, many people don’t have an awareness of how common and difficult infertility is, so they ask questions that might be difficult for the person who is struggling.

Questions like, “When are you going to have kids?” and “What are you waiting for?” can be painful for a person with infertility to hear. So in general, it’s a good idea to avoid questions like that altogether.

When we see someone we love struggle, it’s natural to want to be encouraging and say something like, “I’m sure it will work out!” or, “Stay positive, it will happen for you!” Unfortunately, you don’t know that it actually will work out. And even if it does, it may still be a tough road getting there. 

Even if that’s not your intention, comments like these are likely to make the person feel like you don’t understand, or that you think their feelings aren’t valid. That can lead to them not wanting to share their experience with you and isolating themselves, which can make the process even more difficult.

And after a while of being told what I should be feeling (positive and hopeful), I just stopped telling people how I was actually feeling (hopeful but sad) - it was much less triggering to just cry alone on a park bench.

If your friend expresses hopefulness and positivity you can of course encourage that. But don’t force a positive outlook on them.

This doesn’t mean that optimism is forbidden. But instead of saying, “It will happen when the time is right, everything happens for a reason,” you can say things like, “I really hope this will happen for you,” or “No matter what happens, I am here for you.” You can even let them know that you’ll hold onto hope for them on days when they don’t feel it themselves.

How to support a friend going through infertility. How friends can be helpful when going through infertility

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