What Not To Say To Someone Who's Undergoing IVF

In an attempt to be helpful, and because so often people get uncomfortable or nervous and just start babbling, friends, acquaintances, and co-workers often say things to people undergoing IVF that are hurtful. As Chrissy Teigen has pointed out, simply asking someone if they’re pregnant can cut pretty deep.

Remember that someone undergoing IVF is often incredibly vulnerable. Someone who is normally skeptical might believe the most suspect anecdotes or advice. What, for you, is an offhand comment about someone getting pregnant after eating a bag of purple M&Ms could lead to your friend frantically googling where to buy purple M&Ms in bulk.

In other words, what you say matters. Your friend could use your ear much more than your words.

As someone who has been through four IVF cycles, the gold standard for testing out a statement is this: Would you say its corollary to a friend facing an unintended pregnancy? Similarly, a lot of the supposedly helpful advice people lob at IVF patients sends a nonsensical message: that they could make pregnancy happen by doing or thinking the right things.

For example, a holistically minded midwife once told me that “a baby is born into a relationship,” and maybe my wife and I had some things we should be working on. (We did. We do. But that wasn’t what was stopping us from getting pregnant.) Looking back now, years later, no longer in the grip of infertility and able to think with some clarity again, I wonder if this same midwife would tell a client whose pregnancy was unwanted that perhaps she and her partner were getting along too well. That she wouldn’t have gotten pregnant if only they had fought more.

Here are a few more things people often say that, at first glance, seem innocuous, but can cause further anguish for someone who already is dealing with enough of that, thank you.

• “Try to relax.” Seeing your friend tense and tearful, of course your first instinct is to make them less miserable. But it’s nearly impossible to calm down when the entirety of your bank account is sitting in a petri dish in a lab somewhere.
• “I have a cousin whose best friend’s sister…” Please, stop before you finish that sentence. Your friend already knows the story: They tried everything, years and years, then they adopted, and then they got pregnant! The moment they stopped trying! It can’t be a coincidence! Except, it totally can. Infertility isn’t the same thing as sterility. Eventually, many infertile couples do conceive, even without medical assistance, though it often takes years and is never a guarantee — hence, by the time the miracle pregnancy occurs, some people have already adopted. And the people who adopted and then never did get pregnant? There’s lots of them, too, but no one is repeating their stories.
• “Have you tried…” Usually this means acupuncture, which, to its credit, doesn’t require thinking a person can control their own fertility with a little more effort. But acupuncture is rarely covered by insurance, and it’s not cheap. So if your friend can’t afford it, it can feel like a failure to leave no stone unturned. Which ends up being just another way to feel like they’re not pregnant yet because they’re not trying hard enough. I remember drinking $400/week of Chinese medicinal teas not because I had money to burn, or because I am a real adherent of Chinese medicine, but because I couldn’t free myself from the incarcerating thought of what if?
• “You have time.” We know that fertility declines with age, most significantly after age 35. But ovarian reserve varies between person to person, and hoping for a pregnancy in your forties isn’t going to make it so. Also, even if your friend is young, there might be other restraints pulling at them. Insurance coverage for IVF may be limited to a certain number of cycles, for example. Money is finite. And we each have our own limit to how much suffering we’re willing to endure on the path to having children. So even though it might be possible to use donor eggs to get pregnant well into your 50s, or beyond, that doesn’t mean it’s a realistic option for the person you’re talking to.
• “You have options.” Technically, this may be true. Your friend might at some point explore the possibilities of donor eggs, embryo adoption, surrogacy, or child adoption. But they may not be there yet. Getting pregnant with your own eggs is a common (though by no means universal) desire, and when it comes, it tends to come on strong. It’s not fair to expect your friend just overcome these strong urges. They will need time to mourn before moving on to other options, all of which are expensive and require serious ethical considerations.
• “If it’s meant to be, it’ll happen.” Seriously? Kids with cancer, is that meant to be? A gift from a benevolent God?

As an alternative, here are a few things I’m sure your friend would love to hear you say:

• “I’m so sorry you’re going through this.” Be real. Acknowledge that this sucks.
• “I can’t imagine how you must feel.” Admitting this is helpful. Don’t try to make comparisons unless you’ve actually been there.
• “I’m here to listen.” These words can mean the most. Don’t forget to follow through by giving your friend lots of space to speak.
• “Do you want me to _____ or _____?” Sometimes asking for help is hard, even when someone has invited you with a “let me know what I can do.” It can be helpful to give your friend a couple of options to pick from.

The kindest thing anyone said to me over the course of our IVF cycles came from the male doctor who did one of our embryo transfers. I was on my way out the door, and he said, “Go home and try not to–” but he stopped himself. Maybe it was how desperate I looked, or maybe he realized the faulty logic of what he was about to say.

“Actually,” he continued, “go ahead and worry all you want. It won’t make a bit of difference.”

And with that, I released a sigh of relief. Of course I would worry. It would be two miserable, interminable weeks of waiting. I had no control over whether or not the embryo stuck and grew into a pregnancy. And if I got my heart broken again, it wasn’t my fault. This one kind, insightful comment freed me for a moment from the blame I’d been dumping at my own feet for years.