As a reproductive endocrinologist, I hear about a lot of insensitive "tips" given to my patients throughout their fertility journey. Patients will tell me they have heard that if they just stop worrying, they will magically get pregnant, or that a specific diet will help.
But here's the truth: there is often a medical reason behind why someone has been unable to successfully conceive a baby on their own. But even in cases of unexplained infertility, no amount of meditation or luxury vacations can erase their real need for medical assistance. And, with 1 in 8 couples experiencing fertility challenges, there are likely many more people around you going through infertility than you may realize.
Here are some of the most common (unsolicited) pieces of advice given to those navigating a fertility journey, why they can be so damaging, and what you can say instead.
What You Shouldn't Say
Just do IVF
As a doctor who helps patients conceive with the help of in vitro fertilization (IVF), I am grateful that this advanced treatment option exists for those who need it. However, not every patient requires it, it's certainly not the "easy way out," and there are no guarantees that it will work for every person.
There are three main levels of fertility treatment: medicated cycles, intrauterine insemination (IUI), and IVF. Unless there is a medical reason to skip straight to IVF, such as age, male factor fertility issues, or blocked fallopian tubes, most fertility specialists counsel their patients to start with the least invasive option first and then move to the next level of treatment if needed. IVF is our best treatment option by far, but it is complex and can be costly. It can be physically and emotionally challenging for some patients.
While success rates at high-quality IVF centers are about 60 percent liveborn rate per embryo transferred—good IVF centers will only transfer one embryo at a time to reduce risk of multiples and risks to the pregnant person and their baby, in line with the current guidance from the American Society of Reproductive Medicine (ASRM)—there is also never a 100 percent guarantee that it will work.
Maybe you're just not meant to be a parent
Ouch. Really? Let's avoid this one altogether. Telling someone who desperately wants to have a child that they shouldn't have this dream or they should just give up and move on is cruel and insensitive.
Just relax
I can't tell you how many times patients come to me and say they have heard this. While this advice may be well-intended, it places blame on the person trying to conceive. You simply cannot "relax" your way into a successful pregnancy if you have legitimate medical issues preventing you from conceiving.
You can have one of mine
Please don't jokingly offer up one of your own children to someone struggling with infertility. It just makes light of how much they want children of their own and makes them feel like their dreams of having a family don't matter.
You just need to take a vacation
Suggesting that a legitimate medical issue can be solved with a simple relaxing vacation feels like a slap in the face to most fertility patients. While it can sometimes be healthy to take a break from treatment, telling someone that taking a vacation will fix their fertility issues is frustrating.
When you stop thinking about it, it will happen
This is another common phrase my patients hear all the time. It insinuates that the person is overthinking things and possibly even causing their own infertility by "trying too hard." That if they simply stop thinking about how desperately they want to become a parent, it will magically happen for them. This is not only bad advice but potentially harmful too. Encouraging someone to wait to seek help means they will delay medically necessary treatments and possibly make things worse by waiting too long.
Why don't you just adopt?
The problem with this suggestion is twofold: it both minimizes the complex financial, emotional, and logistical process of adoption and insinuates that adoption is simply a backup plan for someone who can't have biological children. Adoption is a beautiful option for many families, and should be treated with respect—not offered up as an easy "Plan B."
Have you tried … ?
I can guarantee you from daily personal experience that the last place anyone wants to have to go is a fertility clinic. They have already likely tried everything under the sun to get pregnant before reaching out to a professional. Suggesting a diet you heard about on the news or an old wives' tale is not helpful. Unless someone explicitly asks for advice, it's best to keep these ideas to yourself and not intrude on this deeply personal issue.
We tried for two months; I know how you feel
Without minimizing the frustration of trying to conceive, let's be honest: trying for two months on your own with no diagnosed medical issues versus trying for two years with the help of a fertility specialist is very different. Instead of attempting to empathize by comparing your situation to theirs, simply accept that you likely can't comprehend the magnitude of what they're going through.
It could always be worse
While your intentions may be good, saying this really diminishes the suffering of someone with fertility struggles. Recognize that you can't compare pain and acknowledge that what they're going through is incredibly difficult and stressful. Validation of feelings is a powerful way to help someone but minimizing what they're going through is not.
Everything happens for a reason
Would you say this to someone just diagnosed with a terminal illness? (Hopefully, your answer is a hard no.) Apply the same logic to someone going through fertility challenges. No matter their belief system, offering this not-so-comforting phrase minimizes what they are dealing with while possibly reinforcing their biggest fear: that they simply aren't meant to have a baby.
What You Can Say Instead
Want to offer genuine support and empathy to someone going through fertility struggles? Ditch the "advice" above and try one of these responses instead:
- It must be so hard to still not have a baby in your arms.
- I know how much you want this.
- I'm sorry it has been such a long road.
- You would/will be such a wonderful parent.
- I am really hoping that this works out for you.
- I'm here for you.
- Wow, that sounds exhausting. How are you coping with all of this?
- I know I can't fix it, but I am always happy to listen if you need to talk.
- Is there anything I can do to help? (For example, bring a meal during a fertility treatment cycle or offer to take them out to see a movie to distract them.)
Remember: you don't have to have the perfect response or know exactly what to do. Simply offering a listening ear and a safe place for your friend or family member to express how they're feeling as they navigate infertility is the biggest gift you can give them.
Joshua Hurwitz, M.D., is a partner in reproductive endocrinology at Illume Fertility and is board-certified in both Obstetrics & Gynecology and Reproductive Endocrinology and Infertility
