Fact: 1 out of 8 couples suffers from infertility.

Let’s narrow it down - that means that if you open your phone and look at the recent people who you have texted or called over the last few weeks, there is a good chance that at least one or more of your friends are struggling or have struggled with fertility.

Many of your friends who have dealt with infertility will never open up about their struggle and you may never know that they had issues.

Infertility encompass a wide rage of issues, which including the inability to become pregnant after a year or more of trying to conceive, secondary infertility (struggling to have a second/third/fourth child), or the loss of a pregnancy/stillborn.

Many couples choose not to share these private struggles with close friends and family, mainly as there is nothing outside of a sperm, an egg, a doctor and God that can help in any way. Its a helpless feeling, knowing that you have the inability to create life, something that people take for granted every day.

You may not know it, but the passing remarks or comments that you think are helpful or ‘okay’ to say to that couple who you think may be struggling with fertility, can cause unintentional and unimaginable hurt to a couple who are struggling with fertility.

And for the couples who do choose to open up about their struggle, there are many times where friends and family do not know what to do or say, or they do and say things that are hurtful and unintentionally insensitive. This can cause relationships to become distant, awkward and broken, when the real root of the problem stems from a lack of knowledge of what to do or say to comfort the ones we love.

The argument is frequently made, that a couple who is struggling with fertility should not be so sensitive and should not block others out of their lives or be upset when someone says something that accidently hurts them. After all, no one is trying to make things worse, only offering help and support, right?

Yes. Each day, people with infertility learn not to take things to heart - they get hurt, they deal with failed fertility treatments and insensitive comments from doctors and friends and family, and then they get stronger. But a lot of this strength comes from becoming jaded and the barriers couples put to up protect themselves from callus remarks and the inevitable pain associated with conversations surrounding fertility and children. Women who undergo fertility treatments may be more sensitive than they normally would be. They take daily hormone altering medications and can not always can they be the rock they may usually be - a funny joke by a friend about being thankful she doesn't have a baby to wake her up in the middle of the night, can lead to anger and tears, when typically, she may have had the internal strength to know that her friends made a mistake was not trying to be insensitive.

To counter the above argument, if we truly love and support those who struggle with the extremely difficult and heartbreaking reality associated with fertility issues, then it should be incumbent on us to learn how to treat them, not the other way around. We need to learn what to say / what not to say, and in that manner, learn to be a more compassionate and a loving support system for our friends.

Below are a number of tips on how to be sensitive to our friends and family who are struggling with infertility. (These tips have been compiled from over 150 women around America who currently struggle with fertility.)

15 Sensitivity Tips For What to Say to Friends Who are Struggling With Fertility

1. Avoid the question, “How many kids do you have?”

WHY: This is difficult for those trying to conceive who’ve never gotten pregnant as well as those who have miscarried or have lost a child(ren). For those who have experienced miscarriages/stillborn, a parent (especially a mother) will always remember how many children she has carried so this comment can be very hurtful to respond to. A child at any stage who has been lost will always “count” to a parent. Not sure how to approach this question? Let others volunteer information about their children if they wish first.

2. Avoid the questions, “How long have you been married?... No kids yet?” or “When are you going to have another baby?”

WHY? Don’t assume that it’s ok question/comment on one’s plans to start a family or add onto a family as many couples do not want to answer with, “We have been trying for [2, 4, 10] years and don’t have a kid yet/only have one kid.”

3. Don’t assume that a couple who doesn’t have children or has one child is “focused on their careers” and has no time for kids or doesn’t want kids.

WHY? There are a lot of couples who gloss over the discussion of having children with a comment of “kids are not in the cards for us for a while” or “I want to focus on my career”, which may be a way of saying - i.e: “We don't have money for fertility treatment at the moment and are working so we can save the money we need”. Basically, its not our job to assume or judge based on what we perceive a situation to be.

4. Don’t say, “You guys are so lucky you don’t have kids now – you can be free to do whatever you want.”

WHY? Couples who are struggling with infertility want nothing more than to be tied down with a baby and not be able to “paint the town red.” Making light of the situation and brushing it off with a “you’re so lucky” comment can be extremely hurtful.

5. Never say, “You’re young, you have time before you have to start trying,” “Don’t try right away,” “Give yourself time to get to know one another” or, conversely, “You should have a baby before [such and such age].”

WHY? The choice of when to start having children is never a topic for a friend or family member (including a parent) to comment on. It is the couple’s choice when to start, and is a private discussion that occurs between husband and wife. This is a sacred and private aspect of a marriage. In addition, if someone has decided to open up to you and share their struggle, it means that they are sharing something so private, making them extremely vulnerable and exposed. Many need an ear, not an insensitive “wave it off” comment.

6. If you know of a couple who have a few kids and are trying to conceive, have lost a pregnancy, or have had a stillborn, a hurtful thing to say to them are the “silver-lining” one-liners. ie: “At least you have a kid/kids”, “Be glad for the kids you have”, “Maybe you were only meant to have [1, 2, 3, etc.]” or “it was a blessing to lose the pregnancy - maybe the baby wouldn’t have survived anyways.”

WHY? This one should be obvious, but unfortunately it is said very commonly, more times than we would like to believe. Such a comment can cause irreparable damage. If you don't know what to say, avoid the “silver-lining” and “it happened for a reason” one liners.

7. Don’t ask another person’s child, “Don’t you want a little sister/brother?”

WHY? So many people ask young children this question and children are usually unaware of the struggle parents go through. This comment can hurt a child or cause the child to put pressure on the parents who are already trying to do all they can as they deal with their infertility issues.

8. Try not to complain in any way about your kids in front of a childless couple.

WHY? Hearing how annoyed you are that they woke you in the middle of the night, how frustrated you are with your crying baby, how your kids drive you crazy, how carpool is “the worst,” how you got no sleep and “miss the days you were free like you guys,” how hard it is to be a parent, etc. is extremely insensitive. Couples struggling with infertility would give anything to hold a crying baby in their arms and have a sleepless night.

9. If possible, plan a night out with a couple who doesn’t have kids.

WHY? Helping someone challenged by infertility feel like they still “fit in” even though they don’t have children helps them know they have your friendship even though they don’t share the common bond of being a parent. A lot of pain comes from feeling “left out” and not having anything in common with friends who are parents.

10. If someone you know has told you they are struggling with infertility, check in regularly and say you are thinking of them and wondering how they are feeling.

WHY? This is much better than saying, “Thinking of you and your struggle” or “How are your treatments going” or “When is your next fertility treatment”? If someone you really care about is struggling, let them know you are praying for them and that you are there no matter what – they will open up to you if they feel comfortable and ready to share the intimate struggles they are going through.

11. Avoid the following hurtful comments: “Why don’t you adopt?” or “We know someone who adopted and then got pregnant right after” or “There are so many kids who need adopting” or “Maybe this is a sign from God it’s not going to happen for you naturally.”

WHY? The choice to adopt or expand a family in a variety of ways is deeply personal, and you can trust they are weighing all the options without needing such unsolicited advice from others.

12. Try to avoid offering lifestyle suggestions such as what to eat or drink, going organic, putting one’s legs up, catching the next full moon, doing yoga, and avoiding certain foods.

WHY? Remember, you are not a doctor. What worked for you or a person you know, or something you read online is not always going to work for someone else. Many fertility issues need to be corrected with intense medical treatment, and some can never be corrected for various reasons. Your input is only another painful reminder of the struggle they are dealing with. If couples are looking for suggestions, they will ask for advice. Unsolicited advice is usually very unwelcomed and can have the opposite effect than what was intended.

13. The comment, “Just relax, it will happen,” can be offensive becomes it comes across as the reason for the infertility being stress.

WHY? Infertility is a medical issue and especially painful – a lot of stress stems from the pain of not being able to be a parent and less from the medical diagnosis. In addition, the couple will never not stress. Infertility is a daily struggle--everywhere a couple turns they are reminded of children (e.g., on Facebook, in synagogue, commercials, movies, at the mall, etc.). People struggling with fertility cannot escape it and every day these reminders add to their burden.

14. Religious suggestions such as: “Get a blessing from this holly man,” “Try this good luck charm,” “say this prayer,” are unsolicited pieces of advice.

WHY? Many people do all of the above for years and still, no child. These suggestions can, in fact, turn couples away from God and their religion. When prayers, blessings, or good luck charms don’t seem to be working, they can easily start to lose faith. Unless they ask, don’t offer your two cents. Instead, giving suggestions, ask if you can pray for them or forget talking about fertility and invite them to synagogue or church outings or potlucks and other gatherings. It’s less about trying to find a “magical potion” that gets them pregnant, and more about letting them know that you have their back and support them, being there for them spiritually and emotionally and that their struggle is important to you.

15. Lastly, its important to remember that everyone who goes through the emotional trauma associated with fertility issues, deals with it differently. 

Some want to be open, some want to be closed, some find healing in crying alone and other find healing in soliciting friends and family to create a support system for them. Its most important to remember to listen to what they say, pay special attention to their body language and know when they just need a hug or a distraction (like going a coffee/lunch/walk/whatever your friend likes to do to relax). You will quickly learn what works for your friend and what doesn't and that talking about fertility issues is a lot different than talking about other problems you guys have dealt with in the past. Let them know you love them, that their pain is your pain and that you are so happy that they choose you to open up to.