I have sat with patients who have just received a negative pregnancy test and watched a single sentence from a relative hurt them more than the injection they had endured that morning. “Just relax.” “You are still young.” “My friend tried once and it worked.” “Have you tried putting your legs up?”
So, if you are searching for what not to say to someone with infertility, the short answer is this: do not offer casual advice, comparisons, forced optimism, or explanations for a medical problem you have not taken the time to understand. Do not ask when they will have a baby. Do not suggest that stress caused the infertility. Do not treat IVF as a minor inconvenience that will disappear if they take a holiday.
Say instead: “I am sorry this is so difficult. I am here if you want to talk, and I will not give advice unless you ask for it.” That sentence is not clever. It is not memorable. It is usually exactly what is needed.
I have written about how to support a friend going through infertility before. I am returning to the subject because I continue to see the same avoidable damage in my clinic. The people causing it are rarely cruel. They are usually frightened, awkward, or desperate to make the pain go away. But good intentions do not make bad words harmless.
The same sentence can mean two entirely different things
There are two conversations that often look identical from the outside.
In the first, a woman tells her sister that her embryo transfer has failed. Her sister responds, “Don’t worry, it will happen next time.” She means, “I love you and I cannot bear to see you suffer.”
In the second, the same woman hears the same sentence from a colleague who knows nothing about her treatment, has never asked how she is coping, and is already pregnant with her third child. She hears, “Your grief is inconvenient. Please stop talking about it.”
The words are the same. The relationship, timing, and emotional history are different. This is why a list of forbidden sentences can never replace basic empathy. Still, some sentences are so predictably unhelpful that we should retire them.
| What is said | What the speaker usually means | What the patient may hear |
|---|---|---|
| “Just relax.” | “I hope things work out.” | “Your anxiety is causing this, and you are failing to control it.” |
| “You are still young.” | “There is still hope.” | “Your present pain does not count.” |
| “My friend conceived after a holiday.” | “I am sharing a hopeful story.” | “You have not tried the obvious solution.” |
| “Why don’t you adopt?” | “I want you to have a family somehow.” | “Your wish for a biological child is selfish or foolish.” |
| “At least you already have one child.” | “You have something to be grateful for.” | “You are not allowed to grieve secondary infertility.” |
The last example deserves special attention. Infertility after the birth of a child is often dismissed because people assume that one child cancels the longing for another. It does not. A person can be deeply grateful for the child she has and still be heartbroken about the child she cannot conceive. Human emotions do not obey accounting rules.
“Just relax” is not medical advice
This is the sentence I dislike most.
Infertility has many causes. There may be problems with ovulation, blocked or damaged fallopian tubes, endometriosis, diminished ovarian reserve, sperm production, sperm movement, or a combination of factors. Sometimes we do not find a clear explanation even after appropriate testing. Some of these problems are present from birth. Others develop over time. None is cured by being told to relax.
I sometimes tell patients, half jokingly, that if relaxation were the treatment for infertility, I would run a spa rather than an IVF clinic. IVF requires trained doctors, nurses, embryologists, laboratory equipment, careful monitoring, and decisions that are often medically complicated. A holiday may be pleasant. It is not a substitute for diagnosis.
There is another problem with “just relax”. It quietly transfers responsibility to the patient. If the next cycle fails, she may conclude that she did not relax sufficiently. Perhaps she worried too much. Perhaps she worked too hard. Perhaps she had an argument with her husband. She is already carrying injections, appointments, expense, uncertainty, and social pressure. We should not add the burden of believing that her emotions caused the disease.
If relaxing were the solution to infertility, I would be managing a day spa rather than an IVF clinic.
Stress is unpleasant and deserves care. Counselling, exercise, sleep, meditation, and supportive relationships may help someone cope with treatment. But coping better is not the same as curing infertility. We must not confuse the two.
Do not turn someone else’s success into a promise
“My cousin had three failed cycles and then became pregnant.”
“My neighbour tried for ten years and now has twins.”
“My friend stopped thinking about it and conceived naturally.”
I understand why people tell these stories. They want to provide hope. Unfortunately, hope becomes a threat when it is presented as a guarantee.
Every IVF cycle contains uncertainty. Even when the medical plan is sound and the laboratory work is excellent, an embryo may not implant. A pregnancy may end in miscarriage. A cycle may be cancelled. A couple may reach a point where they must decide whether to continue, pause, use donor gametes, consider adoption, or stop treatment. These are not moral tests. They are difficult personal decisions made under emotional and financial pressure.
When someone says, “It worked for my friend after the eighteenth attempt,” the patient may hear that she is not permitted to stop after the third, fourth, or sixth attempt. The story can turn persistence into a duty. It can make stopping feel like giving up on a child rather than making a reasonable decision about her own health and resources.
I have seen this same mistake in angel investing. A founder hears that another startup raised money after twenty investor meetings and concludes that she must keep pitching indefinitely. But someone else’s outcome does not tell you what your own probability or runway is. The relevant question is not, “Did it work for them?” It is, “What do we know about this case, and what decision makes sense for us now?” Patients deserve the same honesty that founders deserve.
Do not prescribe food, sex positions, supplements, or internet folklore
Most couples undergoing IVF have already searched far more than you imagine. They have read medical websites late at night. They have joined WhatsApp groups. They have watched videos, compared protocols, spoken to other patients, and collected a drawer full of supplements. They have probably heard about pineapple, beetroot, avocado, chia seeds, seed cycling, special underwear, acupuncture, avoiding cold foods, and keeping the legs elevated after intercourse.
You do not need to add another theory.
There is nothing wrong with eating nutritious food or taking reasonable care of one’s health. The problem begins when ordinary lifestyle advice is presented as a treatment, especially when it implies that failure is the patient’s fault. “Did you eat enough protein?” can sound like, “You caused the failed cycle by eating the wrong dinner.”
Supplements deserve particular caution. Some are harmless; some interact with medication; some are expensive; some are contaminated or inadequately tested. A doctor who knows the patient’s history should decide whether they have a place. A relative who saw a reel on Instagram should not be writing the protocol.
The same applies to advice about sex. Asking intrusive questions about frequency, position, timing, or lubrication is not support. Fertility treatment already makes intimacy feel clinical for many couples. It does not need a family committee conducting an audit.
Do not ask questions that force disclosure
In India, family gatherings can become fertility interrogations.
“When are you giving us good news?”
“Why are you waiting?”
“Are you pregnant? You are not drinking.”
“When will I become a grandmother?”
These questions are often treated as harmless conversation. They are not harmless to the person who has just had a miscarriage, is waiting for a beta-hCG result, has had an embryo transfer, or is deciding whether she can afford another cycle.
The person may smile, change the subject, or make a joke. That does not mean the question was acceptable. Many patients become skilled at hiding distress because they do not want to spoil a family celebration. Their silence is not evidence that they are fine.
A good rule is simple: pregnancy is private medical information. Do not ask unless the person has clearly invited the conversation. This applies even to parents and siblings. Love does not create a right to know every detail of another adult’s reproductive life.
If you are the one going through treatment, you are also allowed to prepare a sentence and repeat it:
- “We are dealing with a private medical matter and do not want to discuss it.”
- “Please do not ask us about pregnancy.”
- “We will tell you if and when we have news.”
You do not owe a long explanation. You do not have to defend your decision to keep treatment private. Boundaries are not ingratitude.
“You are young” can be as painful as it is reassuring
Age matters in fertility. It affects the number and quality of eggs, the likelihood of miscarriage, and the chances of success with treatment. But “you are young” is not a diagnosis, and it does not erase the present problem.
A 29-year-old with severe endometriosis may be struggling with a real medical condition. A 32-year-old with very low ovarian reserve may have limited time. A young man may have severely impaired sperm production. Telling them that they have plenty of time may be factually wrong, and even when it is broadly reassuring, it can feel dismissive.
People also use age to invalidate grief. “You are only 30; why are you so upset?” This is a strange standard. We do not tell someone with a broken leg that she is too young to feel pain. We do not tell someone with cancer that he has many years ahead and therefore should not be frightened. A hopeful prognosis and present suffering can exist together.
If you want to communicate hope, make it conditional and honest: “I know your doctor has said there are still options. I also know this is painful right now. I am here with you while you work out what you want to do.”
Do not compare one person’s treatment with another’s
IVF is not one standard procedure with one predictable result. The treatment plan depends on age, ovarian reserve, sperm parameters, previous treatment, medical history, laboratory findings, and the couple’s preferences. One person may need stimulation and egg retrieval. Another may need donor eggs. A third may need surgery before treatment. A fourth may decide that IVF is not right for her.
Even within one family, two people can have entirely different experiences.
“My sister had only five injections.”
“My doctor transferred two embryos.”
“Why are you paying so much?”
“Why are you doing another test?”
These comments encourage patients to shop for the treatment that sounds easiest or cheapest, without understanding why their doctor has recommended a particular approach. Cost matters enormously in India, and patients should ask for transparent estimates. But comparing bills at a family dinner is not a substitute for informed consent.
I encourage patients to ask their doctor three direct questions:
- “What problem are we trying to solve?”
- “What are the reasonable alternatives?”
- “What will we do if this cycle does not work?”
Those questions are more useful than collecting anecdotes from ten acquaintances. I have written separately about whether to tell your boss you are doing IVF, because treatment affects work, privacy, and finances in ways that outsiders often underestimate.
Do not tell a patient to be grateful
“At least you have a supportive husband.”
“At least you can afford IVF.”
“At least you already have one child.”
“At least it is not cancer.”
All of these statements may contain a fact. None of them is comfort.
Gratitude and grief are not opposites. A couple may be grateful that they can pay for treatment and still be terrified that the money will be wasted. A woman may love her first child and still grieve secondary infertility. A patient may have a wonderful partner and still feel lonely in her body.
When we say “at least”, we are usually trying to rank suffering. We are telling the person that someone else has it worse and therefore she should stop complaining. This is not compassion. It is emotional bookkeeping.
The same error appears in education and investing. A student who is struggling is told that many children have no school at all. A founder who has lost a company is told that at least she learnt something. Both statements may be true, but neither addresses the person in front of us. A fact can be true and still be badly timed.
What should you say instead?
I prefer short, specific statements that leave the patient in control.
| Situation | Useful response |
|---|---|
| They disclose that they are undergoing IVF | “Thank you for telling me. You do not have to explain anything you do not want to.” |
| They report a failed cycle | “I am sorry. Do you want me to listen, distract you, or help with something practical?” |
| They are awaiting results | “I will not keep asking for updates. Message me when you feel ready.” |
| They cancel a social event | “No explanation needed. I hope the day is manageable. I am here.” |
| You want to help but know little about IVF | “I do not know enough to advise you, but I can listen or help with transport, food, or appointments.” |
Practical help is often better than verbal reassurance. Offer to drive someone to the clinic. Send dinner after egg retrieval. Look after a child during an appointment. Do not demand an immediate reply to your messages. Remember the date of a procedure without asking for a result. If you are close enough, ask what kind of support is welcome.
And ask permission before giving advice. “Would you like me to share something I have heard, or would you prefer that I simply listen?” If the answer is no, accept it without looking offended. The patient is already making enough difficult decisions.
What if you have already said the wrong thing?
Most people who read this will recognise something they have said. I certainly have. Doctors are not immune to clumsy reassurance. We are trained to solve problems, and sometimes we rush to solutions when the patient needs us to acknowledge the problem first.
A simple apology is enough:
“I am sorry. I realise that what I said was dismissive. I do not understand everything you are going through, but I care about you. I will listen rather than offer advice.”
Do not add, “But I only meant well.” That makes the apology about your intention rather than their experience. Good intentions matter, but they do not cancel impact.
Do not ask the patient to reassure you. She should not have to say, “No, no, it was fine,” because you feel uncomfortable. Let the apology stand.
The sentence I wish every family would remember
Infertility is not merely an unsuccessful attempt to become pregnant. It can involve repeated hope and disappointment, invasive procedures, financial strain, marital tension, grief after miscarriage, fear about age, and the humiliation of being questioned by people who believe they are entitled to an answer. The patient may be functioning at work and smiling at dinner while privately counting follicles, injections, embryos, rupees, and days.
That does not mean every person undergoing IVF wants to be treated as fragile. Many want normal conversation. Many do not want their treatment to become the centre of their identity. Ask them what they need rather than assuming. Some days they may want to discuss cricket or a startup. Some days they may want to cry. Both are reasonable.
The most respectful response is not optimism, advice, or a story about somebody else. It is presence without pressure.
When a patient tells me that a relative said, “Just relax, it will happen,” I often wish I could speak to that relative directly. I would say: you do not have to solve infertility. You do not have to produce a miracle. You only have to stop making the person prove that her pain is real.