In an ideal world, every person dealing with infertility would be surrounded by the loving support of their social circle. In reality, infertility can be an isolating experience for many patients. There is still some sense of stigma and shame around the topic, although things are getting better.

In the last few years there have been great strides towards normalizing fertility treatment: the media now generally covers stories about new research with a respectful and sympathetic tone, familiar and beloved celebrities have begun to be open about their own experiences with infertility, and IVF and other treatments are becoming so common that almost everyone knows at least one family in their lives that has been through it. Knowing that society in general is more accepting of the issue of infertility is helpful, but when it comes to talking with the people closest to you, things can be more complicated.

To tell or not to tell?

Talking about infertility can be a double-edged sword. When you are open about your journey, you can feel less alone, you can ask for help when you need it, and you help to dispel the remaining stigma. When you do share, however, you open yourself up to many potentially painful experiences.

You may encounter family objections on religious or cultural grounds. You might need to deal with well-meant but hurtful “advice” from friends who don’t understand the realities of infertility and treatment. While growing your family is ultimately a private matter, you may find that as soon as you disclose that you are “trying” suddenly every random acquaintance and stranger suddenly has an opinion.

When you consider all of this, keeping your treatment a secret may begin to look like a more attractive option, but it has its own drawbacks. When the people in your circle don’t know you’re struggling, they are more likely to make innocently insensitive comments and ask questions about when you’re planning to have a baby. It can be more difficult to navigate potentially upsetting social events such as baby showers. When you’re having a hard day emotionally or physically and need a break, you can’t explain what’s wrong.

So how do you strike a balance between openness and privacy?

Know your audience

Remember that you don’t need to have a “one size fits all” policy on the matter. Different people in your life are likely to respond with different levels of sensitivity and support. It’s impossible to predict exactly how a person will react: sometimes someone you thought would be enthusiastic might turn out to lack the understanding you expected, while someone you thought would object can surprise you with their support.

Still, you know your relationships best. Elderly family members from a traditional background are likely to have a different reaction than a contemporary friend. You can tailor your approach and the amount of detail you share with each person. Placing people on a “need to know” basis can provide a good guideline for what and when to share.

Have a plan for sharing information

If you are going through treatment with a partner, you should have a conversation about your needs and expectations around the continuum of openness to privacy. You may need to negotiate so that everyone’s comfort levels are respected. Once you have decided what you want to share, it can help to rehearse the planned conversations ahead of time.

Decide on a time and a setting. You don’t want to have to rush, or worry about getting emotional somewhere public. You might consider using different language with different audiences. Some people may be comfortable talking about infertility and the medical terms for treatment, while others may prefer to be more vague and simply say something to the effect of “It’s taking us longer than we expected to get pregnant, so we’re getting help.”

Once you’ve talked to the important people in your life, you will want a plan for how much you are willing to discuss the process on an ongoing basis with each person. If you don’t want to be asked for updates or test results, you can say so, gently. “We’ll let you know when we have any news to share.”

Be willing to educate

When you are dealing with infertility, you quickly become an expert on the subject. The medical and technical details of diagnosis and treatment become second nature: you know the names of every procedure and medication out there, and you can rattle off the details of your cycle on demand. For those outside of the process, it can all seem mysterious and confusing. You may find that your family and friends struggle to understand or relate to what you’re going through. If you are willing to teach them, they will be able to support you better.

Fertility treatment is demanding, and when you’re already using up so much energy, having to educate people on the topic can feel overwhelming. You might want to have some resources on hand to share when it comes up. Our blog has entries on a wide variety of infertility-related subjects: you might want to direct them to a specific article on a topic that comes up in conversation. The National Infertility Association, Resolve, has a whole section just for family and friends.

When it comes to dealing with objections which arise from the stigma around infertility, it’s important to consider your own emotional well-being first. If you think their objections come from a place of ignorance rather than opinion, it may help to share some general information about infertility. You can tell them that this is a common issue, and that one in eight couples struggle with infertility, and refer them to resources, as mentioned above. If you know someone with strong feelings on the subject, remember that it is not your responsibility to try to change their mind. It may be in your best interest to just limit what you share with them.

Ask for support, and be specific

Even with the best intentions in the word, the people around you may not know how to help you. They love you, and it can be difficult for them to see you suffering. Just like educating them on the medical aspects of infertility, you may need to teach them how to deal with the emotional side of the situation. Framing this teaching as a request for support can give people more “buy in.” When you ask someone for help and are specific about what you need from them, it can make a big difference for everyone.

Here are a few examples:

• To those offering advice such as “you just need to relax” or “just adopt” or “not being a parent isn’t a big deal.” “We’re working with fertility experts, so we need to concentrate on their advice right now. I’m going through a lot, and some days I’m just full of grief and anger and need to let it out. If you can just listen without giving me advice, it will help me process.”
• To your friends with young children: “It’s really hard for me to be around little ones right now, but I still need to see my friends. It would mean a lot to me if we could make a lunch date.”
• To friends planning parties: “Sometimes I might not be up to attending events. If I can’t come, please don’t take it personally, and please keep inviting me. That will help so much.”
• To people announcing pregnancies: “I am so happy for you, but at the moment it’s very painful for me to see other people getting pregnant while I’m struggling. It’s really hard to feel so conflicted, and it helps if I can give myself space from the details as I go through this. Thank you so much for understanding.”

While the stigma of infertility has weakened considerably, in some communities and families it is still a major issue. For some people, finding the support they need from the closest people in their life just isn’t possible. This can add further hardship to the challenge of infertility, but it doesn’t mean you need to go through this without company.  There is help and support out there, from people who know what you are going through.

A counselor or therapist with experience around fertility issues can be invaluable. In-person support groups exist in most cities and can be a powerful source of validation and understanding. Many patients have found great solace and support online, from communities who are going through the same thing alongside you. Your Los Angeles fertility clinic should be able to connect you to resources which can help: we are at the front lines with you, working every day to dismantle the stigma of infertility. You are not alone.