What to say to someone who can't get pregnant (and what not to)

“So, when’s it going to happen? You know, the clock’s ticking.”

Sunday lunch, dessert has just arrived on the table. Her aunt says it kindly, with a wink, as if it were a joke everyone is in on. For a moment the table falls silent; someone laughs, someone changes the subject. She smiles, says “we’ll see” and goes to the kitchen to fetch the coffee. There she stands by the counter a little longer than she needs to. Four days ago her period came, after fourteen months of trying and a first unsuccessful round of treatment. Nobody at the table knows.

Her aunt didn’t mean to hurt her. Most people who say something painful to someone who can’t get pregnant don’t do it out of malice. They do it out of ignorance, awkwardness or a wish to help. And yet some sentences sink in deep and stay there for months. This post is for those standing alongside: parents, sisters, friends, colleagues. Everyone who would like to say the right thing — or at least not say the wrong one.

More common than you think

In 2023 the World Health Organization estimated that roughly one in six adults experiences infertility at some point in their life. That means you almost certainly know someone who is going, or has gone, through it — even if they haven’t told you.

And that is the first reason words are so demanding here: you often don’t know you are talking to someone for whom this is painful. The question “when’s it going to happen?” doesn’t only land on people who don’t want children or aren’t planning them yet. It also lands on those who long for a child every day, who count the days of their cycle, and who perhaps lost a pregnancy last week that nobody knew about.

Researchers have shown that what people around us say is not unimportant. In 2003 Mindes and colleagues followed women with fertility problems and found that unsupportive remarks from those close to them — minimising, unsolicited advice, avoidance — predicted greater distress later on. In 2007 Slade and colleagues, studying people attending a fertility clinic for the first time, observed a connected chain: those who experienced infertility as a stigma talked about it less, received less support and felt more distressed. What we say, then, affects whether a person will tell us anything at all next time.

Why words are so hard here

When someone dies, we at least have a few ritual phrases: “I’m so sorry for your loss”, “we’re thinking of you”. For infertility we have none. It is a loss that is hard to put into words, because it didn’t happen in a single moment. It is the loss of something that never was — the child who didn’t come, the future the couple had pictured, a body that doesn’t work the way it should.

In 1989 Kenneth Doka introduced the term disenfranchised grief for losses like this: grief that others don’t see or don’t recognise as legitimate. I wrote more about it in The grief nobody acknowledges: miscarriage, divorce, losing a job. With infertility you feel it at every step. There’s no funeral, no date, no grave. There’s only month after month that ends the same way.

On top of that, infertility doesn’t end. When someone dies, people at least know when the loss happened. Infertility goes on — sometimes for years — and repeats itself with every cycle, every test result, every piece of news about someone else’s pregnancy. In their 2007 review, Cousineau and Domar described how far it reaches: into self-image, the couple’s relationship, sex, work and friendships. That is why a single kind sentence isn’t enough. What matters more than what you say once is how you are with the person over time.

Sentences that hurt — and why

Here are some of the sentences people who can’t get pregnant hear most often. For each one I try to explain what it actually communicates, even if the speaker doesn’t mean it that way.

• “Just relax and it’ll happen.” It says: it’s your fault, you’re too tense. And yet in 2011 Boivin and colleagues, in a meta-analysis of prospective studies, found that emotional distress before starting treatment was not associated with the outcome of treatment. For someone already searching for what they’re doing wrong, this sentence adds one more responsibility.
• “Why don’t you just adopt?” It says: your wish is easily solved and your sadness unnecessary. Adoption can be a wonderful path, but it is a separate, long and demanding decision, not a consolation prize.
• “At least you have each other.” / “You’re still young.” It says: your loss isn’t that big. The little phrase “at least” almost always shrinks the pain instead of acknowledging it.
• “My cousin got pregnant as soon as they stopped thinking about it.” It says: you should stop thinking about it too. Miracle stories are often painful to hear, because they don’t describe the listener, they compare her.
• “Kids are exhausting anyway, be glad you can sleep in.” It says: your wish is naive. The attempt at a joke sounds like mockery.
• “Everything happens for a reason.” It says: there is a meaning in your pain that you have to find. Some people do find meaning for themselves, and that is theirs. When someone else offers it, it works as a way of closing the conversation.
• “So when’s it going to happen?” A question that seems innocent, but puts the person in front of a choice: lie, or reveal something deeply intimate in front of the whole table.

What all these sentences have in common is that they try to fix the pain rather than see it. Something similar happens with depression, and I wrote about it in “Just snap out of it”: why advice from loved ones does not help. Advice is often our way of easing our own helplessness in the face of someone else’s pain.

What you can say instead

The good news is that you don’t need to be original or wise. People going through infertility often say that what helped most were simple, even clumsy sentences — but ones that were honest and didn’t try to fix anything.

• “I’m sorry you’re going through this.” It acknowledges that it’s hard. It explains nothing.
• “I don’t know what to say, but I’d like to be there for you.” Honest helplessness is often more comforting than skilful consolation.
• “Would you like to talk about it, or would you rather talk about something else today?” It offers a choice. Sometimes the most you can do is offer an ordinary evening in which infertility isn’t the main topic.
• “I was thinking of you this week.” Especially if you know there was a result, a procedure or an anniversary that week.
• “What helps you right now — and what gets on your nerves?” A question hardly anyone asks, yet it tells you a great deal.

Behind all these sentences is the same stance, which psychology calls empathy: trying to understand how it is for the other person without telling them how it ought to be. Very similar principles apply when someone has died — I described them in What to say to someone grieving, and what not to (and why silence isn’t a mistake). With infertility, though, there are a few particular things worth knowing.

Things worth knowing

Don’t ask about plans. Even if you know nothing, you can simply avoid asking other people about children. They’ll tell you when they want to. If they don’t, that’s their right.

Don’t ask for details about treatment. “Whose problem is it?”, “How many embryos did they transfer?”, “When’s the next attempt?” People who trust you enough to tell you they’re having treatment haven’t necessarily given you permission to ask medical questions. Whatever they want to share, they will share themselves. How to be there for friends going through treatment is covered in more detail in How to support friends through fertility treatment.

Don’t forget the man. When a couple can’t conceive, sympathy almost always turns towards the woman. The man is often left without anyone asking “how are you?” — and he usually won’t raise it himself. Why that is, is the subject of Male infertility: silence, shame and why nobody talks about it.

Share your own pregnancy differently. If you are pregnant and know that a friend or sister can’t conceive, tell her privately and ideally in a way that lets her respond in peace — perhaps by a message that gives her time. Not in front of the whole family, not over lunch. You might write: “I wanted you to hear it from me and not from someone else. You don’t need to reply. I know it can be both at once — that you’re happy for me and that it hurts.” If she withdraws in the weeks that follow, it isn’t a sign she isn’t happy for you. It’s a sign that this is hard for her.

Don’t expect gratitude. Sometimes you’ll say everything right and the person will still be angry, withdrawn or distant. That isn’t a judgement on you. Infertility sometimes takes so much strength that there’s none left over for politeness.

When you’ve said the wrong thing

If you recognise one of your own sentences while reading this, you’re not alone. Almost everyone has at some point said something they wouldn’t say now. What matters is not never getting it wrong, but knowing how to repair it.

The repair can be very short. Here is an example of a conversation between two sisters (composite, not a real person):

“I’ve been thinking about what I said to you at Mum’s. That you just need to relax.”
“Mm.”
“That was unkind of me. I didn’t know what to say, so I said something stupid. I’m sorry.”
“…It really hurt. I spent the whole week wondering whether it was my fault.”
“It isn’t. If you want to talk, I’m here. If you don’t, I’m here too.”

There are no long explanations in this repair, no justifying why you said it. There is an acknowledgement that it hurt, and an offer that asks for nothing. That is enough. A conversation like this is often more precious than anything you could have got right the first time, because it shows the person that you heard them.

Stay there for months, not days

Infertility isn’t an event, it’s a period of life. So one of the most important things you can do is not to disappear after the first conversation. At the start, people often call, write, ask. After a few months they go quiet, because nothing new is happening — or because they don’t know whether it’s still all right to ask.

For the person living through it, though, some moments stay hard the whole time. If you know them, you can get in touch at exactly those moments. The same principle applies to any long loss — there’s more on how not to disappear in When a colleague or friend is grieving: how to stay longer than a week.

Exercise: before you speak

If you know you’ll soon see someone who can’t get pregnant — at lunch, at work, at a birthday party — you can take five minutes to prepare a little.

1. Remind yourself what you know and what you don’t. Did they tell you themselves, or did you hear it from others? If from others, don’t touch on it in conversation until they open it up.
2. Notice your own discomfort. What are you afraid will happen? That she’ll cry? That you’ll say the wrong thing? The discomfort is yours, and you don’t need to solve it with a comforting sentence.
3. Choose one sentence that doesn’t fix anything. “It’s good to see you.” “I’ve been thinking of you.” If the conversation carries on, good. If not, the sentence was enough.
4. Prepare a way out for others. If someone at the table asks “when’s it going to happen?”, you can change the subject — without explanation and without glancing at her.
5. Afterwards, ask yourself what you noticed. When did she withdraw, when did she relax? That will tell you more about what helps her than any list.

Where this guidance doesn’t apply

I want to be honest here: no list of sentences works for everyone.

Some people want questions. For some, the silence around infertility is worse than even the clumsiest question, because they experience it as a sign that it mustn’t be talked about. Others want humour, others still want detailed conversations about treatment. So the best guide is always the person themselves — and the question “what helps you?” is worth more than this post.

You don’t have to be a therapist. As a friend, sister or colleague you are not responsible for taking someone’s pain away. Your job is to be a person beside them, not a solution. If you are wearing yourself out, it’s right to look after yourself too.

Not everything that hurts is because of you. Someone going through infertility may experience even a completely neutral sentence as painful. That doesn’t mean you made a mistake, and it doesn’t mean you have to tiptoe from now on. It means it’s a hard time.

When to encourage professional help. If you notice that the person has been withdrawing from everyone for weeks, isn’t sleeping or eating, is giving up everything that used to bring joy, or talks about life having no point, gently encourage them to see a GP or a psychotherapist. Medical questions about infertility belong with a gynaecologist or a fertility clinic. For suicidal thoughts in Slovenia, there is the crisis line Klic v duševni stiski on 01 520 99 00 (every day from 7 pm to 7 am) and the Samaritans helpline in Slovenia on 116 123 (24 hours a day); in an emergency, call 112. You’ll find a short explanation of how infertility affects mental health in the knowledge base under infertility and distress, and about pregnancy loss under pregnancy loss.

What to remember

• Roughly one in six adults experiences infertility — you probably know someone going through it, even if they haven’t told you.
• Sentences that hurt try to fix the pain; sentences that help see it.
• Don’t ask about plans or details of treatment; whatever the person wants to share, they will share themselves.
• Don’t forget the man, and share your own pregnancy privately, with room for the other person to respond in peace.
• If you get it wrong, repair it briefly — and stay with the person for months, not just the first week.