The Centers for Disease Control and Prevention (CDC) officially defines infertility as "not being able to get pregnant after one year or more of unprotected sex." That includes trouble either getting pregnant or staying pregnant.
However, those of you who have faced fertility issues, or supported someone through fertility difficulties, know these definitions are merely the tip of the iceberg. They do not encapsulate the incredibly complex and emotional journey that fertility problems bring.
"Even the word 'infertility' can in itself be quite a triggering word," said Jules McGoldrick, a holistic women's health practitioner and owner of Ryecroft Yoga and Wellness, specializing in fertility yoga and fertility support. "Especially when we use it as a blanket term for all things related to struggles conceiving."
Many couples end up at fertility clinics with no diagnosis, no reasons given, told there is no cause, and just branded "infertile" due to "bad luck." That isn't helpful.
Language matters. Many people find it difficult to even talk about their fertility problems. The language we use can be the difference between someone reaching out for support and struggling alone.
"As a society, our fertility struggles and losses are not spoken about openly enough," McGoldrick said. "They are shrouded in secrecy, pain, hushed voices, and sometimes even shame. I think if we opened up the conversation, we could understand how common it is and become more sensitive to those around us."
And it is a common problem. It is estimated that 6 percent of married women in the United States, ages 15 to 44, cannot get pregnant after one year of trying to conceive. Also, about 12 percent of women in the same age bracket in the U.S. have difficulty getting pregnant or carrying a pregnancy to term. That equates to around 1 in 8 couples having trouble getting or staying pregnant.
But, the question is, how do we open up the conversation? How can we best support those around us facing fertility issues?
Be available for support
Meg Arroll, Ph.D., M.Sc., a psychologist, scientist and published author, explained that one of the best ways to support someone through fertility issues is to listen. To really listen. "Often, when someone we care about is talking, we're thinking of what to say next—this isn't truly listening. So, if you find your mind rushing ahead to draft a response, gently nudge it back to what your loved one is saying."
The main thing is to be available for support. Be an ear if they want to talk, to vent, to cry, without pushing.
"If people have been experiencing fertility problems, have been trying to conceive for a long time, have been through unsuccessful rounds of treatment, or experienced pregnancy loss—each month, each cycle can feel like a loss," McGoldrick stated. "Here is real grief. They need emotional support and understanding from those closest to them."
Alyssa Mairanz, LMHC, CDBT, a licensed therapist and owner of Empower Your Mind Therapy (EYMT) practice based in New York City, emphasized the importance of checking in and asking if your loved one needs anything.
"Everyone is different in how they seek comfort, and many people don't feel comfortable asking but would appreciate someone checking in on their needs," Mairanz said. "Remember that this is a journey, so check in often. They might not want anything today, but next week they might take you up on the offer to show your support."
You can also offer to attend difficult appointments. Join your friends in the room if they are comfortable with that or wait outside to meet up afterward, suggested Mairanz. Even offering to cook dinner after an appointment can help. Just knowing you're there and committed to supporting them through this journey can mean so much.
Be engaged in the specific circumstances
"It can really help if you do your research," Mairanz advised. "Read up on fertility issues, possible treatments, or other options your friend is considering, so you are informed when they need to talk."
It's important to be both interested and engaged when discussing fertility problems. It takes a lot to open up about this issue, so it's essential to give it your full attention. "Now is not the time to check your phone while your friend is speaking about their struggles," Mairanz said.
It's also important to know that everyone's fertility problems are a completely individual experience, Arroll said. No two people go through exactly the same thing. Everyone is a unique individual with their own set of circumstances.
"This is why recounting stories of others can be harmful," Arroll said. "It may feel tempting to tell your friend or loved one about someone you know who tried X or Y, and this resulted in a live birth. But this may not be the case for the person who is experiencing fertility issues."
Arroll explained that this verges on a type of toxic positivity, which can lead to feelings of guilt and shame if the outcome differs for the person you're trying to support.
Be conscious of your language
Rather than offering solutions or advice, McGoldrick said it's best to be conscious of your language and just acknowledge your friend or loved one. Say you're sorry they are going through this, that it absolutely sucks, and that you are there for them.
Arroll agreed you should avoid anything that sounds like advice. Stay away from statements such as:
- "Oh, just try to relax, and it will happen."
- "You can always adopt."
- "I know loads of people without kids who are very happy."
"These nullify what is an incredibly difficult journey and will shut down the conversation," Arroll explained. "Also, 'You're going to make a great mum/dad' is another phrase to avoid, as there are certainly no guarantees when it comes to infertility. in vitro fertilization (IVF) and other methods are not magic bullets for many people."
Mairanz added some additional do's and don'ts of things to say:
- Don't diminish the struggle. Infertility reaches everyone differently and can be a devastating journey that comes with hard choices and treatments. Try not to belittle the issue or push it aside in the conversation.
- Don't ask whose "fault" it is. It doesn't matter who is struggling with infertility in the relationship. If they want to disclose this information, they will tell you directly.
- Do ask if they want to talk about it.
- Do say, "I'm here to listen whenever you need me."
- Do ask, "What can I do to help?"
- Do support their decisions. If they choose to stop infertility treatments and look at other options, be supportive and lend an ear when they are ready to talk with you. It can be a heartbreaking decision. They need to know you are there to hold them up during an emotionally agonizing time.
"While a lot of advice like 'try not to overthink it' comes from a place of well-meaning, it's not helpful, and we often don't understand the depths of pain people can be in when it comes to trying to conceive a long-awaited baby," McGoldrick said. "Just be thoughtful, conscious, and there for them if they want to reach out to you."