How to support a friend going through infertility

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.

What is infertility?

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.

What treatments are available?

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?

  • Medications that stimulate ovulation
  • Lifestyle changes that aim to correct hormonal imbalances or improve sperm quality
  • Surgical procedures
  • IUI (intrauterine insemination)
  • IVF (in vitro fertilization)
  • Using donated sperm, eggs or embryos
  • Surrogacy
  • 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. 

How does infertility affect a person?

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 ashamed or like a failure
  • 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.

Make it easy to opt-out

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.

Don’t stop asking

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. 

What if someone isn’t sharing?

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.

What NOT to ask

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.

2. You don’t have to be positive

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.

- Anna

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.

3. Focus on listening instead of giving advice

Your friend has probably spent countless hours researching infertility. Between conversations with doctors and online searches, they almost certainly understand their diagnosis and treatment options better than you do. 

You might have read about a new supplement they can take, or saw someone post about a new technique to analyze embryos, and it’s great that you want to help. But they have probably already considered, tried, or ruled out anything you might suggest, and it is likely that what you suggest isn’t relevant to their case. It’s important to remember that infertility is a really complex diagnosis, and there’s no such thing as “one size fits all.”

Giving advice therefore often comes off as condescending or ignorant, as if you’re oversimplifying what they’re going through. It’s usually best to refrain from it entirely. If you really want to share an idea, you can first ask them, “Are you open to hearing an idea of something to try?” 

And the dreaded two words that almost everyone with infertility has heard countless times? “Just relax.” There is no science or data to suggest that relaxing is the cure for infertility. So that “advice” is probably not going to be helpful.

Giving your friend your full attention, making space for them to talk about what they’re going through, will likely help them feel more supported.

Focus on their experience instead of other people’s stories

Most people going through infertility have heard about their neighbor’s cousin’s college roommate who did IVF 7 times without success and then magically conceived spontaneously.

It’s wonderful that such stories exist. But they don’t change anything about the situation that your friend is in now. When it comes to infertility, there are no guarantees. Hearing about other people’s success stories can make your friend feel like you’re minimizing what they’re going through and taking the focus away from their experience.

Just like with any advice you want to give, you can always ask your friend if they’d like to hear about someone you know who has been through this. Sometimes it helps people with infertility to hear things went well for someone, giving them hope. But for the most part, while your friend is still in the middle of their infertility experience, it’s a good idea to focus on them instead of other people’s stories.

4. Educate yourself about infertility basics

Even if you may be more helpful supporting your friend emotionally than giving fertility advice, they may still appreciate it if you understand some of the basics.

They might want to talk to you about what they’re going through, but the idea of educating you about the basics of fertility feels exhausting and daunting.

If you can take some time to google things for yourself, you give them room to focus on what they’re going through, rather than teaching you biology. Every person’s experience is different, but if you know about the general mechanics of IVF, or what terms like “AMH” and “blastocyst” mean, you’re relieving them of some of the burden and allowing them to go straight to the things they want to talk to you about.

Here are a few articles that can be helpful:

5. Be gentle with pregnancy announcements and talking about your kids

Your friend might be the person you used to always go to first when you had good news. But now that they’re struggling with infertility, consider how you want to share your pregnancy announcement and kids’ milestones with them.

Sharing pregnancy announcements

Receiving pregnancy announcements can be painful for people with fertility struggles. It’s a reminder that others can, often easily or even accidentally, have the one thing they so desperately desire.

If you want to share good news about a pregnancy or milestone about your child or someone else’s, do so gently. You can ask them how they’d like to hear news like that; they might prefer to hear via text so they don’t feel pressured to look or react a certain way.

Your friend might feel sad, resentful or envious of you when you share about your or someone else’s pregnancy. They likely feel bad about their reaction, so try to let them know that whatever they’re feeling is okay.

Your friend might want or need some space after hearing about your or someone else’s good news. Remember that it’s not personal; they are going through something incredibly difficult, and while they probably feel happy for you, they are also feeling sad in their own experience. Give them space, and let them know that you’re here for them whenever they feel ready to connect with you.

Baby functions

When it comes to baby functions, like baby showers and birthday parties, you can absolutely still invite your friend. They will probably appreciate being included, not wanting to be left out of life events. It’s important that they can choose for themselves if they’d like to attend or not. You can acknowledge that hearing about or attending the event might be hard for them, and that it’s okay for them to say no or cancel at the last minute if they’re not feeling up for it.

Talking about your kids

Be mindful when talking about kids in general. You probably wouldn't call your friend who's mid-divorce to tell them about your partner's romantic surprise, or complain about your mother to someone whose mother recently passed away. Your kids are naturally a big part of your life and there is no reason to hide that, but your friend will likely appreciate it if you are intentional about how often and how much you share about your children with them.

6. Help out with daily tasks

Infertility and fertility treatments can be draining and overwhelming. If your friend is going to a lot of doctor’s visits, is on medication, or is struggling with their mental health, doing life tasks like cooking meals and running errands can be extra difficult.

It’s a nice idea to ask how you can help. It’s even better if you can take action without them having to make a specific ask. Let them know that you’re going to order them dinner tonight, or drop off some household essentials. It’s a great way to show them that you’re there for them, and it takes things off their to-do list.

7. Keep your friendship full and fun

To your friend, it might feel like infertility has taken over their life. They might have trouble making plans or thinking about anything other than what they’re going through.

While it’s great that you can talk to them about fertility, as we’ve explored above, another way to support them is to keep your friendship alive in other ways.

Take them to their favorite restaurant, keep your monthly bowling nights going, invite them to game night, or try a yoga class together. You can help them get out there and enjoy day-to-day life. Having fun together and not focusing on infertility can be a meaningful and welcome distraction.

8. Be kind to yourself

You may find that it’s impossible to always say the “right” thing, and it just might be. When someone is struggling and experiencing anxiety, they may not know what they need themselves. And what they find helpful can change from day to day. One day they may want you to ask about the process, and another day they might only want distractions. 

All you can do is make the effort to show up for your friend however you can. If they ever seem annoyed or angry, or even distance themselves from you, it may be more about them struggling than it is about you doing something wrong. Just knowing that you’re there for them, even when there’s distance, can mean a lot.

And remember, your own well-being is important too. If you don’t have the energy to show up sometimes, it’s okay to tell your friend that you don’t have space to listen or be there. Setting boundaries is an important way to honor your own needs and show respect for your friendship.

2023-01-12

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