How to talk – and not to talk – about infertility

Joshua Hurwitz, M.D., a partner in reproductive endocrinology at Harrison- and Fairfield County-based Illume Fertility, offers suggestions on what to say, and not to say, to those grappling with infertility.

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 why a couple has been unable to successfully conceive a baby on their own. Even in cases of unexplained infertility, no amount of meditation can erase the real need for medical assistance. With one in eight 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 pieces of “advice” given to those navigating a fertility journey, why they can be so damaging and what to say instead. 

‘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% live-born baby rate per embryo transferred, good IVF centers will only transfer one embryo at a time to reduce risk of multiples and risks to the mother and the baby — in line with the current guidance from the American Society of Reproductive Medicine (ASRM). There is also never a 100% guarantee that it will work.

‘Just relax.’

I can’t tell you how many times patients come to me and say that 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. 

‘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 for a real medical issue 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.”

‘Everything happens for a reason.’

Would you say this to someone just diagnosed with terminal cancer? (I hope your answer is a hard “no.”) Apply the same logic to someone going through fertility challenges. No matter your belief system, offering this not-so-comforting phrase minimizes what the couple are dealing with while possibly reinforcing their biggest fear — that they simply aren’t meant to have a baby. 

What to 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 not to have a baby in your arms still.”

“I’m here for you.”

“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?”

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 friends or family members 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 and gynecology and reproductive endocrinology and infertility. For more, visit

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