If you have difficulty conceiving, it’s comforting to know that in vitro fertilization is an option. That said, no one ever actually wants to go through IVF. The process involves money, hormones, self-administered shots (often in your butt or stomach), and a lot of emotional highs and lows. And it doesn’t help that people don’t really know how to act around you when you’re going through it.
“IVF was very, very emotional and very isolating for me,” Karen, the woman behind the popular Instagram account Hilariously Infertile, tells SELF. (Karen doesn’t like to reveal her last name because she’s a teacher and her students know how to Google.) “The shots are painful, your skin where you’re injecting hurts, and emotionally, it’s really draining,” she says. Karen says her friends and family tried to be supportive but ultimately, “they didn’t get it.”
The first two cycles of IVF were pretty positive for Shannon M. Clark, M.D., founder of BabiesAfter35.com, but she tells SELF she struggled to stay upbeat during subsequent cycles (she did five in all). “I was more reluctant to talk about it and my friends were less likely to ask,” she says. “I’m sure they felt awkward and didn’t know what to say.”
And, even if that silence is well-intentioned, it can leave the person going through IVF feeling alone. “No one even mentioned it or asked me how I was doing, I think because they were worried they’d upset me,” says Sarah*, a woman who went through a few cycles of IVF before getting pregnant. “I felt like a pariah.”
With all of that in mind, we talked to women who have been through this process—as well as fertility experts who deal with this every day—to find out what you should and shouldn’t say to someone going through IVF.
Sarah says a colleague suggested adoption to her when she was just starting her first round of IVF—and it devastated her. “I went home and cried for a solid hour,” she says.
If a friend is struggling with fertility, it makes sense that you’d want to help find a positive spin on things. But, while adoption is great for many families, it’s not something people who are actively trying to conceive want to hear. “Telling a couple they can adopt is hurtful and insulting,” Laurence Jacobs, M.D., a reproductive endocrinologist at Fertility Centers of Illinois, tells SELF. “The statement assumes they were ignorant to their options and discounts their desire to have a biological child.” Also, he points out, “adoption is not for everyone.”
A little empathy can go a long way. “The best things to say, according to a close doctor friend who went through all of this, includes empathetic statements that don’t pretend to really understand what the patient is going through,” Daniel Shapiro, M.D. a reproductive endocrinologist at Prelude Fertility, tells SELF. Dr. Clark says she heard something similar from a friend and it was the best thing she was told during her experience.
True, sometimes couples end up conceiving when they stop actively trying to make a baby, but being stressed 24/7 isn’t why most couples are struggling to get pregnant.
“Never tell people it's all in their head and that they should simply relax,” reproductive endocrinologist Wendy Chang, M.D., F.A.C.O.G., at Southern California Reproductive Center, tells SELF. “Infertility is a true medical diagnosis with well-established causes and treatment.” Plus, as Karen points out, it’s really, really hard to relax when you’re going through IVF. Dr. Clark agrees: “There is no way that a couple undergoing IVF will be stress-free.”
Sometimes when you don’t know what to say, just saying that you’re there for them can go a long way. “This kind of verbal commitment can help them feel supported, loved, and acknowledged,” Dr. Chang says.
Karen says she recently had a friend who ran out of embryos and was devastated. Karen didn’t know what to say, so she was just there to listen. “There really is a grieving process and people need to understand that,” she says. Dr. Clark says when she was going through IVF, she had a friend who would check in with her periodically to arrange a lunch here and there where she could talk about her IVF experience or not if she wasn’t up for it. “She was very patient and always available, and I knew that,” Dr. Clark says.
Again, it’s well-meaning, but it’s pretty likely that your friend has tried everything—including things you haven’t even heard of before. “Before resorting to IVF, most couples have tried many things to get pregnant,” Dr. Clark says. Dr. Jacobs agrees. “Couples with infertility have likely exhausted every option prior to treatment, and have spent a lot of time doing research and possibly blaming themselves for their fertility issues,” he says. “Don't ever offer unsolicited advice about trying to conceive—the less said the better.”
While it’s important to listen to your friend talk about her struggle, it can also be a welcome relief to talk about something else. “It was important to me to be able to talk about IVF but it was also nice to change the subject,” Sarah says. “All I did was think about IVF and it seriously bummed me out!” Time and space can help with the process, Dr. Jacobs says, and suggesting that you do something new together or talking about something else here and there can be helpful.
Unfortunately, IVF isn’t a guarantee, and success rates vary with age. The most recent available data from the Centers for Disease Control and Prevention, puts success rates around 50 percent at age 30, 21 percent for women in their late 30s, and lower beyond that. “IVF doesn’t always work the first time and sometimes it doesn’t work at all,” says Clark, who used an egg donor to have her children after multiple rounds of IVF didn’t work for her. Staying upbeat is important, but your friend is also aware that it might not work. Try something like “your doctors sound like they know what they’re doing!” instead.
It's tough when a close friend is going through fertility issues and you’re either pregnant or already have kids. This statement ultimately depends on how close you are, but if it’s a good friend, Karen says it can be helpful to make it clear you’re not ignoring the elephant in the room—and then let your friend decide how they want to handle it.
“Baby showers and birthday parties are doubly difficult because it is a reminder of the child they long for as well as an occasion to put on a happy face during a time of sadness, which is hard when you are so discouraged,” Dr. Jacobs says. “It is perfectly OK to pass these up.” Dr. Clark says a friend once sent her an invite to a baby shower that said, “I understand that you may not want to come but I want you to know that I am thinking about you and you are invited.” “That was perfect,” she says.
If you slip up and say something on the "don't" list, don't freak out. "Even though we're hopped up on hormones, we're still your friend," says Sarah. "We ultimately know that you're just trying to help."
*Name has been changed.
Related:
- 8 Reasons To See A Fertility Specialist
- FYI: Struggling With Infertility Doesn’t Mean You’ll Never Get Pregnant
- I Froze My Eggs at Age 15…and Did It Again at Age 19
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