A few years ago, after not getting my period for almost a year and not getting pregnant either, I went to my ob-gyn and some basic hormonal screening showed that something was amiss. I was referred to a fertility specialist, a reproductive endocrinologist (RE), and after another month of testing, I found out not only did I have fertility issues, but I was also a carrier for a rare genetic disorder. I was also told I needed to gain weight — my hormones were affecting my metabolism, which led to a year of trying to gain 10 pounds in a safe and healthy way (and to keep those pounds from fleeing off my body).
Finally, nearly two years after I went off birth control, I was ready to begin the arduous work of IVF. That meant daily monitoring appointments with my fertility specialist at what felt like the crack of dawn, shots that required me to face my fear of needles every single night, and constant exhaustion and overwhelming anxiety from wondering if this whole long and difficult (and expensive) process would even result in the baby so badly wanted.
Then a well-meaning person in my life told me she could relate to what I was going through because it took her three months to get pregnant. And not with IVF, mind you, but the old-fashioned way. Yes, a seemingly intelligent person tried to make a case for the fact that three months of having sex with her spouse was the same as the years of what I had gone through physically and emotionally.
And my inner voice went, Nope. All. The. Nope.
I’m now lucky enough to be mom to one amazing IVF-created kid, but during the process, I found there were some people — even well-intentioned ones — who just didn’t know what to say or how to act. Here are some things that I would love the uninitiated to know when talking to friends and loved ones dealing with IVF:
1. For the love of God, please don’t tell us to “just relax.” (Or worse still, “just relax — it will happen on its own!”)
If you know someone who is at the point when she’s seeing an RE and is actively pursuing IVF, then not only is baby-making almost definitely not going to “happen on its own,” but telling her to “just relax” diminishes the long road she’s already walked in her pursuit of motherhood.
If you’re at an RE, you’ve already most likely been trying to conceive for at least a year on your own and likely have tried less invasive fertility treatments like oral medications to induce ovulation under the supervision of an ob-gyn. By the time you’re doing IVF, you’re exhausted, overwhelmed, fearful, and anxious. You’ve suffered through the stress of moving through different medical evaluations, pursuing a diagnosis while suspecting something is very wrong. The reality of becoming a parent already feels like a distant, and potentially unrealistic, possibility.
IVF patients have already experienced a world of hope, defeat, and mourning — all while being unsure of what the future holds. So please understand if they give you the stink-eye when you tell them to relax.
2. No, I’m not actually pregnant — I’m just really bloated from the meds.
The first part of an IVF cycle involves injecting yourself (or, if you are a weeny like me, ask your super-nice cousin who is a nurse to inject you) with a cocktail of medications designed to stimulate the ovaries and produce mature egg cells, leading up to the day when those eggs will be retrieved so embryos can then be, hopefully, made and ultimately transferred into your uterus in an attempt to create pregnancy.
But as your body goes into overdrive to make eggs, your abdomen will, literally, carry the load. So if you have a friend undergoing IVF who is suddenly rocking what appears to be a baby bump overnight, don’t rush over and ask her if she’s picked a name yet. She’s probably still far from that even being a reality — and also, probably missing her skinny jeans.
3. I don’t mind telling you how much IVF costs, but don’t just shrug like that number is no big deal.
Right before I was about to start IVF, a friend of a friend asked me how much an average cycle costs. This question doesn’t bother me: I wish we all talked more about how much IVF costs and how little insurance coverage there is for it. If everyone had more information, we could lobby for change around this issue to allow more people to grow their families in the ways that are best for them.And so I explained that it is not covered by insurance in most states, and even if some parts of the procedure (like diagnostic testing) are covered, the whole process rarely is. Add in medications and, in my case, PGD (preimplantation genetic diagnosis) and PGS (preimplantation genetic screening), and you are easily looking at $20,000 each time you try to have a baby.
The question-asker then replied, “Oh — so it’s not that much.”
Here’s the thing: If spending $20,000 each time you try to get pregnant is no big deal to you, good for you. (And also will you adopt me? Or at least take me on a nice vacation?) But please recognize that it’s no small amount for most of the world. The financial burden alone is a huge contributor to the stress surrounding IVF. People pursuing IVF make a lot of financial sacrifices, all in the name of trying to become parents, so be gracious in acknowledging this.
4. I really don’t hate you, but I just may not be able to bring myself to go to your baby shower.
No, really, I don’t hate you, I swear. And if you are the high-school friend whose baby shower I bailed on last-minute as I was in the midst of my IVF cycle reading this, I’m sorry I no-showed. Please know I was so, so happy for you, but I knew I couldn’t be emotionally present the way you deserved at your shower. You deserved nothing but joy that day. And since I couldn’t bring that, and couldn’t handle being confronted with a successful pregnancy, I didn’t come. I’m sorry.
If you have friends who cancel on baby-related events in your own life while pursuing fertility treatment, keep in mind they’re exhausted, bloated, and overwhelmed. And know they’re still there for you — and share in your happiness — even if they can’t bring themselves to physically be there.
5. Related: I really don’t hate you, but I just may not be able to bring myself to like your Facebook photos.
OK, listen, I will like pictures of your cute kids. But pictures from the aforementioned baby shower? Or your ultrasound photo? Sorry for being a jerk and not liking those, but the truth is that at the time, I didn’t like them. I actually hated them a little. They felt like repeated punches to the gut for me, reminders of what I was struggling so hard to achieve, that I had no idea if I would ultimately be able to.
If you have friends going through IVF, give them a pass if they might seem virtually absent too.
6. Likewise: I really don’t hate you, but I can’t go out because I have to get shots at the same time every night, and they require refrigeration.
No, your friends going through IVF haven’t become “boring moms” already. First of all, don’t make mom jokes at the expense of someone who is struggling to become a mom. But second of all, and even more important, unless you want to schlep around a cooler filled with meds and needles and a sharps container to dispose of all my biomedical waste all in the name of going out for tacos and margaritas, then, no, your IVF pals might not be up for a lot of fun with you on the weekend.
Please know they still think you’re fun and awesome — and hope that you still think they’re fun and awesome too. They hope you want to hang out again, but they need to get through their cycle first.
7. There is no such thing as “just” adopting.
This is a really important one. Adopting a baby is not like adopting a puppy — you can’t just show up someplace and leave with a cute baby in need of a home. There are a lot of paths that lead people — on both sides of the equation — to adoption, and none of them are necessarily simple or without their own respective experiences of loss, grief, and mourning. Adoption is a process that requires lots of time and money and legal assistance and all sorts of steps that still don’t guarantee an outcome. And also, adoption might be a great choice for some people but just not feel right to others. And that choice is a deeply personal one that touches on a whole lot of questions involving identity — both yours and your future child’s — and should never just be casually hefted onto someone the way you might suggest just grabbing burgers if your neighborhood sushi place is closed.
8. I really don’t like the term “miracle babies.”
Even if you struggled with infertility yourself, please think twice before calling any baby — your baby, my baby, a stranger’s baby — a “miracle.” Because when you do, it feels like you’re saying that those dealing with infertility are not presently worthy of miracles. And if IVF has taught me anything, it’s that all babies who make their way into the world are miracles, no matter how they are made or where they come from. Those dealing with infertility aren’t unlucky or unforgotten or undeserving. They are reckoning with real medical issues. So instead of talking about miracle babies, let’s instead praise the miracle of science that works so hard to help those struggling to have children see their dream fulfilled.
9. Your emotional generosity (and links to ridiculous things on the internet) mean more than you’ll ever know.
Did you send me links to cat videos? Celebrity gossip? Ask me if I thought you should buy a pair of shoes you saw online? Well, then, BLESS YOU. Because while IVF patients want desperately to be parents, we still want to be ourselves too. And that means we still want to discuss The Bachelor and laugh at memes. IVF is a constant waiting game: Once you begin a cycle, you’re waiting to see every day what your hormone levels are and how many follicles your ovaries are showing. The day of your egg retrieval, you first wait to see how many eggs will actually be retrieved. Then you wait to see how many eggs will actually successfully fertilize and become embryos. And once those fertilized eggs become embryos, you wait for another three to five days to see how many of those embryos will still be growing and thriving and available for transfer. Meanwhile, before your embryo transfer, you have the weeks of building up the uterine lining, going in for monitoring to see if and when it will reach the desired level of thickness that makes implantation even possible. And once an embryo is finally transferred, you wait 10 days to see if you’ll test positive for a chemical pregnancy. Then yes, more waiting, to see if that positive result will be sustained … and sustained … and sustained. You might think a cat video is the last thing we need when we have so much else on our minds, but trust me when I say we welcome the distraction from all the stress and anxiety. Showing that you’re thinking of us — and not just as an infertility patient — means more than you can possibly know.