I saw a couple recently who had stopped attending family functions. They were not being antisocial. They were tired of answering the same question: “Good news कब दे रहे हो?” Each invitation came with the possibility of another pregnancy announcement, another piece of unsolicited advice, or another relative explaining that a holiday would solve everything.
If you want to support someone with infertility, do three things: listen without trying to fix the problem, respect their privacy, and ask what kind of support they want. Do not ask when they will have a baby, recommend an old wives’ remedy, or tell them to relax. Offer practical help, remember that treatment can be physically and financially demanding, and allow them to say no to social occasions without taking offence.
This sounds simple. In practice, it requires restraint. Most people are uncomfortable when somebody they love is in pain. They rush to fill the silence with advice. In infertility, that instinct often makes things worse.
Two friends, two very different responses
Let me contrast two situations I see repeatedly.
In the first, a woman tells her close friend that she has been trying to conceive for two years and is now considering IVF. The friend immediately says, “Don’t worry, you are still young. My cousin drank some herbal powder and conceived. You should go on a holiday and stop thinking about it.” She then asks for the details of the couple’s investigations and casually mentions the problem to two other friends.
Every sentence may have been well intentioned. Taken together, they communicate three damaging messages: your distress is excessive, your medical problem is probably your fault, and your private information is now available for public discussion.
In the second situation, the friend says, “I am sorry. I don’t know what to say, but I am here. Would you prefer that I listen, help with something practical, or leave the subject alone for now?” She does not ask for test results. She does not promise success. Before a baby shower, she sends a private message rather than assuming her friend will attend. When the friend declines, she does not say, “You are being negative.”
The second friend has not cured infertility. She has done something more realistic: she has made a painful period less lonely.
The best support is often not advice. It is making sure that a person does not have to defend their feelings while they are already carrying a medical problem.
Why infertility is so difficult to talk about
Infertility is not only a medical diagnosis. It reaches into marriage, sexuality, money, family expectations, identity and time. A couple may have spent months believing that pregnancy would happen naturally. Each menstrual period then becomes a small bereavement. After several such cycles, even a seemingly harmless question can feel like an accusation.
Many couples also feel shame. They may believe that conception is something everyone else can achieve effortlessly, while they have somehow failed at a basic adult task. This is medically unfair, but emotions do not wait for fairness. Men may feel embarrassed about semen testing or sexual performance. Women may blame their age, body, lifestyle or past decisions. Sometimes one partner is carrying the diagnosis and both partners are carrying the distress.
Treatment adds another layer. IVF can involve injections, scans, blood tests, egg retrieval, anaesthesia, uncertainty and substantial expense. It can also make intimacy feel scheduled and clinical. A couple may be hopeful before an embryo transfer, frightened after it, and unable to think about anything else while waiting for the pregnancy test. If the result is negative, they may have to answer the same question from everyone who knew about the treatment.
This is why “Have you tried IVF?” is not a neutral question. They may already be doing IVF. They may have decided against it. They may not be able to afford it. They may have had an unsuccessful cycle. Or they may not want to discuss their reproductive plans with you.
How to support someone with infertility: start with permission
When a friend shares this with me, I suggest beginning with one sentence: “Thank you for telling me. What would be helpful right now?”
That question gives the person control. They may want to talk. They may want distraction. They may want help finding a doctor. They may want you to accompany them to an appointment. They may want you to behave as if nothing has happened for the next two hours. Their answer can change from day to day.
Listening is not the same as waiting for your turn to speak. It means allowing anger, sadness and envy without correcting them. If your friend says, “I cannot bear another pregnancy announcement,” do not reply, “You should be happy for others.” She may be happy for the pregnant person and still be devastated about her own situation. Both feelings can exist together.
If you do not know what to say, say exactly that. “I don’t know how to make this better, but I can listen.” This is far kinder than pretending that a positive attitude, a temple visit or a dietary change will solve a complex medical problem.
There is a useful distinction between support and treatment. Your friend may need a fertility specialist, a counsellor, a financial plan or a second opinion. You can help her reach those resources. You cannot provide the treatment by offering confidence.
What not to say—and what to say instead
Some remarks are so common in India that people no longer hear how intrusive they are.
| What people often say | Why it hurts | A better alternative |
|---|---|---|
| “When are you planning to have children?” | It assumes the couple has chosen not to have children and demands private information in public. | Do not ask. Let them raise the subject. |
| “Just relax. It will happen.” | It implies that anxiety is the cause and that the couple is failing to relax properly. | “This sounds very hard. I am here if you want to talk.” |
| “Go on a holiday.” | A holiday may be enjoyable, but it is not a treatment for blocked tubes, severe male-factor infertility or diminished ovarian reserve. | Offer to help with an ordinary task or give them space. |
| “Have you tried IVF?” | They may already have tried it, may not want it, or may be unable to pay for it. | “Would you like help finding reliable medical information?” |
| “You are young. It will be fine.” | You do not know their diagnosis or prognosis, and no one can promise an outcome. | “I hope things work out, but I will not make promises I cannot keep.” |
| “Why don’t you adopt?” | It treats adoption as a quick substitute and may dismiss the grief associated with wanting a biological child. | Discuss adoption only if they bring it up. |
| “My neighbour took this medicine and conceived.” | One anecdote is not a diagnosis, and unverified treatments can waste money or cause harm. | Ask whether they want help checking a treatment with their doctor. |
I am particularly wary of the phrase “think positive”. Hope can help somebody endure treatment. It cannot alter every biological factor affecting conception. Worse, it can make a person feel responsible for every negative thought. If the cycle fails, they may wonder whether they were insufficiently optimistic.
There is no moral virtue in being cheerful during infertility. A person is allowed to have a bad day.
Respect the privacy of both partners
Infertility is often discussed as if it belongs to the woman. This is wrong medically and unfair emotionally. Male factors contribute to a substantial proportion of infertility cases, and both partners should be evaluated when a couple has difficulty conceiving. Yet families may question the woman first, comment on her weight, recommend supplements, and ignore the husband entirely.
Do not ask, “What is wrong with her?” Do not ask the husband for a semen report as a joke. Do not assume that a couple has authorised you to discuss one partner’s medical details with the other. A diagnosis is not family property.
Confidentiality is not a technicality. If somebody tells you that they are undergoing IVF, do not tell your mother, office colleagues or the wider WhatsApp group. Do not post a congratulatory message until they have announced a pregnancy themselves. Even a successful pregnancy may remain private for a while, especially after previous losses or failed cycles.
In my clinic, I have seen the damage caused when ten relatives know about an embryo transfer. The couple is then not only waiting for a result; they are managing ten people’s expectations. A negative pregnancy test becomes a public failure. The couple may have to comfort the relatives who were “so sure it would work”.
Offer practical help, not just sympathetic words
Fertility treatment can be logistically exhausting. The couple may need to travel to another city, arrange leave from work, manage injections, attend early-morning scans, or pay for investigations that were not in their original budget. A friend can help in concrete ways without becoming intrusive.
- Ask before acting. “Would it help if I drove you to the appointment?” is better than arriving uninvited or contacting a doctor on their behalf.
- Make ordinary life easier. Offer a meal, pick up medicines, look after a pet, or help with a work commitment. These small acts can matter more than inspirational messages.
- Help them find reliable information. If they want a second opinion, suggest checking the doctor’s qualifications, the clinic’s counselling process, the likely costs and what is included. Do not forward ten miracle-cure videos.
- Be available around difficult dates. Egg retrieval, embryo transfer, the pregnancy test, an anniversary of a miscarriage, Mother’s Day and family weddings may all be emotionally loaded.
- Accept a refusal. If they do not want company, do not interpret it as rejection. Send one kind message and leave the door open.
Money requires special sensitivity. Do not ask, “How much have you spent?” unless they invite the discussion. Do not offer a loan in a way that makes them feel indebted. If you are close enough to help financially, be explicit about whether it is a gift or a loan, and do not attach emotional conditions to it. “I will pay for this, but you must use my doctor” is not support; it is control.
Nor should friends encourage couples to keep paying indefinitely without understanding the likely benefit. I have written elsewhere about what the struggle of infertility taught me about persistence and uncertainty. Persistence is admirable, but repeating an intervention without learning from the previous attempt is not persistence. It is simply spending more money while postponing a difficult decision.
Pregnancy announcements need care
This is one of the hardest situations for friends to handle. You may be pregnant yourself while somebody close to you is undergoing infertility treatment. You are not required to hide your pregnancy. But you can share the news with kindness.
A private message or phone call is usually better than an announcement at a crowded dinner. Give your friend time to process it. Do not demand an immediate enthusiastic response. Do not say, “I was so worried about telling you because of your problem,” which makes your pregnancy about her infertility. Say, “I wanted you to hear this privately. I care about you, and there is no pressure to reply immediately.”
After the announcement, let her decide whether she wants details about scans, names or the baby shower. She may want to be involved. She may not. Both choices are legitimate.
The same applies to social media. A friend may mute your pregnancy posts without muting the friendship. She may skip a naming ceremony because the event is painful, not because she is jealous of you. A mature friendship can survive a temporary boundary.
When the couple disagrees
Infertility does not affect both partners in exactly the same way. One may want to continue treatment while the other wants a break. One may be ready to discuss donor eggs, donor sperm, surrogacy or adoption while the other cannot bear to hear those words. One may want to tell the family; the other may want complete silence.
Do not become an advocate for one partner against the other. Do not tell the wife that her husband is selfish, or the husband that his wife is overreacting. Encourage them to discuss the decision with a fertility counsellor or a doctor who will explain the medical options clearly. Your role is to preserve trust, not to win an argument.
It is also reasonable for a couple to pause treatment. A pause is not the same as giving up. The body, marriage and bank account may all need recovery. I have seen patients make better decisions after stepping away from the clinic for a few weeks than when they were responding to pressure from relatives.
When support becomes more than friendship
Sadness and frustration are understandable. But if your friend is unable to function, is sleeping very poorly, has persistent hopelessness, is using alcohol or medication to cope, or talks about self-harm, ordinary reassurance is not enough. Encourage professional mental-health support and stay connected. If there is immediate danger, contact local emergency services or a trusted family member who can remain physically present.
Suggesting counselling should not sound like a dismissal: “You are imagining this” or “You need therapy.” A better approach is, “This is a lot for one person to carry. Would you consider speaking to someone who understands infertility?” Counselling is not proof that the person is weak or that the distress is unreal. It is an additional form of care.
Doctors also have a responsibility here. We should not discuss success rates as if a couple were buying a guaranteed product. We should explain uncertainty, costs, alternatives and the possibility of failure before treatment begins. A friend can help by asking, “Do you understand what the doctor has recommended, and do you feel comfortable with the plan?” The friend should not supply false certainty where the medical team has not.
The most useful question is often the least dramatic one
People sometimes believe that supporting a friend through infertility requires a perfect speech. It does not. It requires consistency.
Send a message after the appointment, not only before it. Remember that a failed cycle may hurt weeks after the result. Invite the couple for dinner without making the evening a fertility interrogation. Talk about books, work, food, cricket or anything else they enjoy. Do not make infertility the only subject of the friendship.
At the same time, do not pretend nothing is happening. A message saying, “I was thinking of you today. No need to reply,” can be exactly right. It acknowledges the person without demanding emotional labour from them.
I often tell patients that they should choose one or two trusted people who can know the details, rather than trying to manage a large audience. Friends can make this easier by becoming safe people: discreet, patient and willing to hear the same worry more than once.
Infertility is a problem of biology, but the suffering around it is often made worse by society’s lack of boundaries. In India, relatives may believe that asking personal questions is a sign of affection. It is not affection if the other person has no safe way to decline. A question about children is still intrusive when asked with a smile.
My clearest advice is this: do not try to manufacture hope for your friend. Give them something more dependable—privacy, honest company and practical help. If they want to talk, listen. If they want silence, respect it. If they want medical information, help them find a qualified doctor rather than forwarding an anecdote.
And if you have already said something insensitive, do not defend your intention. Say, “I am sorry. That was clumsy. I did not understand how painful it might be.” Then stop talking and let your friend decide whether to continue the conversation. In my experience, that small apology often does more good than ten reassuring speeches.