We've all had that awkward moment when we've shared sensitive information with a friend, and they responded with something that hurts. Most of us have also been on the other side of this - a friend confides in us, and we respond in the wrong way. As we look at our friend's tense polite smile, we cringe inside, chiding ourselves for putting our foot in our mouth.
Most of the time, insensitive comments aren't meant to be hurtful. They are made out of ignorance or out of a strong desire to say something that will defuse a tense moment. We want to solve our friend's problem, heal their pain, or make light of the situation in a joking manner. Instead, we unintentionally make things worse.
To avoid developing a case of foot-in-mouth disease, read over this list of 12 things not to say to someone with infertility.
What NOT to Say #1: "You can always do IVF."
IVF is often seen as a cure-all for any infertility woe. Can't get pregnant? Just do IVF! Except it's not so simple.
First of all, IVF is a very expensive treatment, rarely covered by insurance in the United States, and frequently only partially covered in other countries. One treatment cycle can cost anywhere between $12,000 and $25,000. However, multiple cycles may be needed to achieve success. One study found that the average cost of IVF treatment per successful birth is $61,377 (or $72,642 for IVF with donor eggs), the higher cost reflecting the need to do more cycles until pregnancy was achieved.
Secondly, IVF is not a cure-all. Even if you have the cash, IVF may not be successful. For women under 35, there's just a 39.6% per cycle success rate, and that will vary depending on the cause of infertility. The IVF success rate for women age 42 to 43 is a low 11.5% per cycle. Some couples may also need donor eggs, sperm, or embryos, or even a surrogate, which is significantly more expensive.
Thirdly, not everyone wants to go through the IVF treatment process. It's an invasive and emotionally intense treatment. While IVF is generally considered safe, it's not without risks. Some have religious objections to IVF. IVF is not for everyone.
What NOT to Say #2: "Just adopt!"
Adoption can be a wonderful option for some couple, but it's not a decision that should be made lightly. Suggesting adoption in a flippant way ignores the financial and emotional costs of adoption.
Also, adoption is not always possible. There's an application and approval process to adopt a child, and not everyone who wants to adopt will pass the screening process. (Not passing the screening process doesn't, by the way, mean the person wouldn't make a great parent. It's more complicated than that.)
Also, adoption doesn't take away the pain of being unable to have a biological child, so offering the option as a comfort doesn't usually go well. Adoption doesn't replace having biological children, but is instead another way to build a family.
What NOT to Say #3: "Trust me, you're lucky you don't have kids!"
Infertile couples aren't clueless. Who hasn't been seated at a restaurant next to a loud, messy family? Or endured a long plane ride next to a screaming baby?
We know babies cry and puke. We know children are messy and loud. We know our lives will change drastically when we have kids. Please don't downplay our loss by making your blessing sound more like a curse.
What NOT to Say #4: "You need to relax. All that stressing is causing your infertility."
This myth is so prevalent that even some doctors repeat it, but everyday stress does not cause infertility. A large study published in BMJ that looked at 3,000 women, from 10 different countries, found that high levels of emotional distress before a treatment cycle did not negatively affect the outcome. In other words, feeling stressed out doesn't prevent your infertile friend from getting pregnant.
You may also want to consider what came first - the stress or the infertility. Your infertile friend probably wasn't stressed out about getting pregnant until she discovered it wasn't happening the way it should.
What NOT to Say #5: "Maybe you're not meant to be parents."
Ah, this one really hurts. If this were true, then how can anyone explain why truly bad and even abusive parents manage to have children? Being qualified for the job is clearly not required.
No one knows why bad things happen to good people. Please don't play God by telling us why we haven't conceived.
What NOT to Say #6: "But you're so young! You have plenty of time to get pregnant."
Not always so. Being young doesn't make you immune to infertility, and time is not always on your side. For example, if a woman has premature ovarian failure (also known as premature ovarian insufficiency), time is not on her side. The longer she waits, the more likely she will need an egg donor. Endometriosis is another condition that worsens with time.
While being younger usually increases the chances of fertility treatment success, it doesn't always, and it never guarantees success.
What NOT to Say #7: "Put your career in front of having a family? Tsk, tsk."
First of all, suggesting that infertility is our fault is insensitive. Even if there may be a tad of truth in it, just don't go there.
Secondly, don't assume we didn't have a child at a younger age because of career. A survey of Canadian women who had just had their first child found that less than 30% of women mentioned career goals as being an important part of their family planning. The top three factors women took into consideration before starting a family were being in a secure relationship (97%), feeling in control of their life (82%), and feeling ready to parent (77%.)
What NOT to Say #8: "What's the big deal, you already have a child."
Secondary infertility - infertility that comes after you've already had a child - is a big deal to the women who face it. Having a child or children doesn't take away the pain of being unable to have more, especially if you've always imagined being the mother of large family or even of two or three children.
And before you tell us to "be grateful" for what we have, don't assume we're not. Couples with secondary infertility really know what a blessing it is to have a child. It is possible to feel grateful for what you have and sad over what you don't at the same time.
What NOT to Say #9: "So, whose fault is it? His or hers?"
Don't assume that since we've confided in you that we're infertile that now we're ready or willing to share all the details.
Infertility needs to be spoken about more, but it is still a personal topic. Please respect our privacy.
What NOT to Say #10: "If you really wanted a baby, you'd have one already. Your mind is probably preventing you from conceiving."
When we're aching to conceive and have a child more than anything, being told we don't want one enough is a real punch to the gut.
Perhaps made popular by The Secret, there are people who truly believe you can prevent pregnancy by just "not really wanting" it to happen. Tell that to all the pregnant women who did not intend to conceive! It's not true. Even if on some unconscious level a woman or man doesn't want to have a child, "not wanting it enough" won't cause infertility.
What NOT to Say #11: "It could be worse. It could be cancer."
This is about as comforting as telling a friend who has just lost their father, "Well, it could be worse. Your mother and your father could have died." Please don't act as the compassion police, determining who deserves compassion and who doesn't.
Interestingly enough, research has found that the emotional distress experienced by women with infertility is similar to the distress experienced by cancer, HIV, and chronic pain patients. (The comments on this blog post, which talk about comparing infertility to cancer, have some heartbreaking responses from former cancer patients who are now infertile.)
What NOT to Say #12: "Whatever you do, don't give up. It'll happen!"
I know this seems like a reassuring thing to say, but unfortunately it isn't. One problem with this is it makes it sound inevitable that things will work out in the end. The truth is they may not. Being told, "Don't worry, it'll happen," tends to be translated internally as, "Stop complaining because it's not a big deal anyway."
The other problem with this statement is it implies "giving up" isn't an option. But deciding to stop treatment, or even deciding not to pursue treatments at all, is sometimes exactly what a couple needs to do.
More on supporting a friend with infertility:
- 10 Things to Stop Doing if You Want to Support Someone with Infertility
- How Can I Support a Friend with Infertility?
- Quiz: Do You Know Infertility Myth from Fact?
- Fertility Facts You Need to Know
Patricia Katz, Jonathan Showstack, James F. Smith, Robert D. Nachtigall, Susan G. Millstein, Holly Wing, Michael L. Eisenberg, Lauri A. Pasch, Mary S. Croughan, and Nancy Adler. "Costs of infertility treatment: Results from an 18-month prospective cohort study." Fertil Steril. 2011 March 1; 95(3): 915-921.
J Boivin, E Griffiths, C A Venetis. "Emotional distress in infertile women and failure of assisted reproductive technologies: meta-analysis of prospective psychosocial studies." BMJ 2011;342:d223.
Suzanne C. Tough, Monica Vekved, Christine Newburn-Cook. "Do Factors That Influence Pregnancy Planning Differ by Maternal Age? A Population-Based Survey." J Obstet Gynaecol Can 2012;34(1):39-46