After treating thousands of infertility patients over the past 23 years, I have heard it all. I see patients during their most vulnerable, hopeful and heartbreaking moments. They often share their struggles and triumphs with me.
One topic that often comes up are the insensitive things that people can say to those who are hoping to become a parent, but haven't been able to have a child yet. Since one in eight couples experiences infertility, awareness of infertility has grown -- but we have a long way to go in infertility etiquette.
People can be insensitive when it comes to painful topics like infertility, and many make hurtful comments, even when they don't mean to. Over the years, patients have shared some of those hurtful comments with me and my colleagues. Here are just a few examples:
"You just need to stop stressing and relax, and it'll happen." "It'll happen one day, just wait your turn." "It was so easy for me to get pregnant! My husband just looked at me and I was pregnant!" "You're not having kids because you are too career-focused." "What a shame, you're a woman and can't have children." "Maybe you're not meant to be a mom. God has other plans for you." "If you just lost a few pounds it would probably happen." "Forget about it, you're trying too hard." "Why don't you just adopt? There are tons of kids that need homes." "You don't know how lucky you are! Kids are expensive and a handful." "I know exactly how you are feeling." "You have two children. Isn't that enough?" "Haven't you learned after five miscarriages that you should be done?" "You can have my children if you want."To help those with infertility as well as the friends and family who love them, I've put together some advice to help navigate conversations without hurt feelings.
Infertility Etiquette: The Dos and Don'ts
If you think you may know someone with infertility, here is some basic advice to follow.
1. Lend a caring, patient ear.
If you know someone who opens up about their infertility, the best response is to listen. Give them a hug and let them share what is on their mind. Don't ask questions or offer advice. By listening, telling them you care and letting them know you are always there for them, you can show your support.
2. Talk about things that are not centered around children or babies.
Make sure that while you are all out to dinner with your spouse and friends that the conversation is something other than kids so that they can laugh and share with you. There are many other topics to discuss such as hobbies, work, current events, etc. If they bring up the topic, it is OK to pursue, but avoid introducing it.
3. Be understanding if they opt out of social obligations.
They aren't skipping the party because they don't care about you; they are opting out because some events can be so painful that their heart aches. Being at events with children or where they could be asked upsetting questions may be a challenge they wish to avoid. Sometimes people need a little space and privacy to grieve as they deal with infertility.
4. Think about what it is like in their shoes.
An infertility diagnosis can cause feelings of shame, inadequacy, depression and isolation. People with infertility often blame themselves for their diagnosis. Be aware and sensitive to what their needs may be, and choose your words wisely.
1. Ask them when they're going to have children.
Prying and pressuring about when there will be children can be extremely hurtful to hear if you are trying for a baby and have not achieved pregnancy. Avoid this question at all costs. Nonetheless, asking how things are going in their life or if they ever need an ear to listen can be very helpful to couple who needs to share.
2. Give advice.
Unless asked a specific question, don't offer unsolicited advice. This includes the topics of adoption, conception, infertility diagnosis, exercise, diet, weight, habits and lifestyle as well as starting, continuing or stopping fertility treatment. You don't know what the couple has done thus far and is going through, and many couples keep this information private. In fact, some couples never share that their baby was conceived through fertility treatment.
3. Say "Just relax. If it's meant to be, it will happen."
These are two of the most common insensitive statements that those with infertility hear, and also some of the most painful. Sadly, they may have heard both of these statements many, many times. Telling someone to relax comes across as disrespectful, blaming and dismissive. To imply that someone is not meant to be a parent is devastating to anyone who longs for a child. Instead, simply saying that as they go through this journey, there are many options to help them. Hope is very powerful and words of encouragement can go a long way.
4. Complain about your pregnancy or children.
While you may be experiencing sleep deprivation, weight gain and swollen feet, someone with infertility longs for the day their pregnancy and child brings about these challenges.
Have you experienced similar situations?
Feel free to comment below and help raise awareness.
10 Fertility Facts You May Not Know
(01 of10)
Open Image Modal1. Your fertility is mostly determined by genetics, which influences how many eggs you are born with. Doctors believe that the number of eggs you have at birth determines the length of time you will remain fertile. At birth, women have about two million eggs in their ovaries. For every egg ovulated during your reproductive life, about 1,000 eggs undergo programmed cell death. Other things, such as smoking cigarettes and certain types of chemotherapy, can accelerate egg cell death and promote an earlier menopause.
(02 of10)
Open Image Modal2. Regular menstrual cycles are a sign of regular ovulation.Most women have regular cycles lasting between 24 and 35 days. This is usually a sign of regular, predictable ovulation. Women who do not ovulate regularly have irregular menstrual cycles. Those who do not ovulate at all may have a genetic condition called polycystic ovarian syndrome (PCOS).
(03 of10)
Open Image Modal3. Basal temperature charting does not predict ovulation.An older method of tracking ovulation involves taking your oral body temperature each morning before getting out of bed. This is called basal body temperature. This method is used to spot a rise in basal temperature, which is a sign that progesterone is being produced. The main problem with using this method is that your temperature rises after ovulation has already occurred. This makes it more difficult to time intercourse at an optimal time for conception. A better method is to use over-the-counter urine ovulation predictor test kits such as Clearblue Easy. These kits test for the hormone that prompts ovulation, which is called luteinizing hormone (LH).
(04 of10)
Open Image Modal4. Most women with blocked fallopian tubes are completely unaware they may have had a prior pelvic infection.About 10 percent of infertility cases are due to tubal disease, either complete blockage or pelvic scarring causing tubal malfunction. One major cause of tubal disease is a prior pelvic infection from a sexually transmitted disease such as chlamydia. These infections can cause so few symptoms that you may be completely unaware your tubes are affected. This is why fertility physicians will order a dye test of the tubes, called a hysterosalpingogram (HSG), if you have been trying and failing to conceive for 6 months or longer.
(05 of10)
Open Image Modal5. In most cases, stress does not cause infertility. Except in rare cases of extreme physical or emotional distress, women will keep ovulating regularly. Conceiving while on vacation is likely less about relaxation than about coincidence and good timing of sex.
(06 of10)
Open Image Modal6. By age 44, most women are infertile, even if they are still ovulating regularly. Even with significant fertility treatment, rates of conception are very low after age 43. Most women who conceive in their mid-40's with fertility treatment are using donated eggs from younger women.
(07 of10)
Open Image Modal7. Having fathered a pregnancy in the past does not guarantee fertility. Sperm counts can change quite a bit with time, so never assume that a prior pregnancy guarantees fertile sperm. Obtaining a semen analysis is the only way to be sure the sperm are still healthy!
(08 of10)
Open Image Modal8. For the most part, diet has little or nothing to do with fertility. Despite popular press, there is little scientific data showing that a particular diet or food promotes fertility. One limited study did suggest a Mediterranean diet with olive oil, fish and legumes may help promote fertility.
(09 of10)
Open Image Modal9. Vitamin D may improve results of fertility treatments. A recent study from the University of Southern California suggested that women who were undergoing fertility treatments, but had low vitamin D levels, might have lower rates of conception. This vitamin is also essential during pregnancy. At Pacific Fertility Center, we recommend our patients take 2,000-4,000 IU per day.
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Open Image Modal10. Being either underweight or overweight is clearly linked with lowered levels of fertility. The evidence in recent years is that obesity is clearly linked with a longer time to conception. Having a body mass index less than 18 or over 32 is associated with problems ovulating and conceiving, as well as problems during pregnancy.
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