Talking with Family, Friends and Strangers about Infertility

Among the many challenges people face going through infertility is determining how to deal with the people they come in contact with. This may include family, close friends, casual friends, acquaintances or even, total strangers. In working with infertile individuals and couples over many years, I have come to believe that most are guided by two principles: distinguishing privacy from secrecy and speaking on a "reason to tell/need to know" basis. In this article I will address both.

Privacy and Secrecy

I once knew a woman who had a blog chronicling her infertility. Each day she posted information about her follicle count, the quality of her embryos, the news of her pregnancy test on a website that could be read by strangers worldwide. For a time the woman found this satisfying and then one day she realized that she was sharing "way way way too much information." It was at this point that she began to realize that she needed to reclaim some privacy.

By contrast, I have met several couples who have taken the "we're private people" approach to an extreme and made their infertility a secret. Unaware of what the couple is going through, family members and friends have innocently made comments such as "you aren't getting any younger-you shouldn't wait too long to have children" or "you have great careers and a fun life together, but don't you think you'll regret not being parents." Suffering in silence, such couples come to realize that when privacy crosses over into secrecy, they pay a price.

So what is the right balance? How can you maintain precious privacy and the dignity that comes with it while avoiding secrecy? I encourage my clients to think about what they want a given individual to know and then to figure out how they will convey this information. Because infertility robs you of feeling you are in control, taking charge of conversations and communicating effectively are all the more important. I encourage my clients to feel that they are the "managers" of their information and to feel comfortable with each interaction. Here are some common situations that may arise:

Most people want their close family members and friends to at least know that they are trying to have a baby but have encountered some difficulty. This basic information helps avoid the suggestion that they are "too selfish" or "too clueless" to attempt pregnancy. However, do they want to say something more such as "we are going through IVF" or "we are being treated at a clinic?" Some feel that providing more information simply leads to uncomfortable questions. In an effort to express support and interest, family members and friends are likely to ask, "How is it going?" or "Any good news yet." Or they may offer advice that is unwelcome and upsetting including, "I just heard of another couple who got pregnant as soon as they stopped treatment and went on vacation" or "Have you thought about adoption."

So…as you contemplate talking with those closest to you, think about whether you will want to have ongoing conversations about your infertility or whether you are best off keeping it simple and letting people know, "No news is no news and when we have some good news, we'll let you know." As you can probably tell, I think there are some real advantages to this "no news" approach but recognize that for some people, offering so little information makes them feel isolated from those closest to them. As one woman said, "I tell my mother what I had for dinner each night, how can I keep basic information about my cycle from her?"

If you do decide to talk with your family and friends about your treatment, remember you will need to educate them, both in the medical aspects of your diagnosis and treatment and on what to say and not say. While most people going through treatment become experts in reproductive medicine very quickly, their loved ones do not. If you seek conversations with them, you will need to explain some of the medical procedures and terminology. More important, however, are the feelings. They will need instruction in such matters as how to best tell you that someone is pregnant, how to offer support that doesn't cause you to feel undermined or defeated, how to help you figure out what to do when you are invited to a baby shower.

Close family and friends pose certain challenges dealing with infertility; colleagues, acquaintances, total strangers pose others. In your work environment you probably have some compelling reasons to maintain privacy but also reasons for not being secretive. If your boss or colleagues know that you are trying to have a baby, they may pass you over for a promotion or new opportunity at work. However, if they don't know and you are often out at doctor's appointments, they may conclude you don't care about the job, are gravely ill or seeking another job.

I have found that most women going through infertility decide to tell people at work the basics of their situation. For men, there are more options not only because there are fewer blood drawings and other medical appointments and because they are not going to be pregnant.

What about acquaintances and strangers? Do they need to know anything about your infertility? In general, the answer is no-I've rarely come upon someone who felt a need or desire to tell people they barely knew that they were going through infertility. However, there are times when you find yourself in a social situation and the "subject" comes up. This can include being at a social gathering with friends of friends who so innocently ask, "How many children do you have?" or, in the case of secondary infertility, "So your daughter is three, when are you going to have another?"

Unlike with family, friends and colleagues, where the goal of conversations about infertility is to provide the information that will maintain and nurture the relationship with the person (while maintaining appropriate privacy), with strangers, the goal is to get through the situation. You don't want to insult someone or sound defensive but do want to convey to them that they have stepped into private territory and you need to maintain that privacy. Many individuals and couples arrive at a line or phrase they will say to people in such situations. This may be, "We'd love to have a baby but it hasn't been so easy. It's best when we're at a party like this to focus on other things" or "We'd sure love to have another child and are working on it as best we can but right now we want to enjoy the wonderful child we have."

Reason to Tell/Need to Know

In distinguishing privacy from secrecy, people inevitably ask themselves whether there is a reason to tell someone about their infertility. It's part of the process of separating privacy from secrecy. However, I think the question steps into the foreground for those considering or pursing egg or sperm donation, adoption, surrogacy.

In pursuing an alternative path to parenthood most people I meet with feel that it is important that they feel comfortable with their choice and do not convey any sense that it is a secret. That said, it is a private matter. For example, newly adoptive parents of a child of the same race quickly discover that when they go out in public with their new baby and people say, "she looks just like you" or "where did she get her blond curls?" there is no reason to blurt out "she's adopted." Similarly, someone pregnant with the help of an egg donor realizes she can simply say, "I'm having a baby in October" without adding, "and it's egg donor."

So there are many times when there is no apparent reason to tell someone that a child was adopted or conceived through an egg or sperm donor. But what of about instances when there is a reason to tell or someone might have a need to know? As they sort out this question, many parents find that certain patterns emerge. Medical caregivers have a need to know that the child's genetic background differs from yours. Family members have a reason and need to know because they will be part of your process and part of the child's life. Similarly, friends should know and in many instances, teachers since there are units in school about the family. By contrast, strangers have no reason to know and telling them may come across as more self conscious and comfortable than honest and secure.

Infertility diagnosis and treatment are hard enough in and of themselves. Having the support and caring of loved ones and the acceptance of colleagues and acquaintances can help lighten your burden. If you are going through infertility, I hope you will feel that those around you are there for you. As you sort out how and when and why to talk with others about your experience, I hope you will see yourself as the manager of your information. Yes, infertility challenges relationships but as a competent and effective communicator, you can maintain and enjoy connections with those who matter most to you.

Ellen S. Glazer, LICSW is a member of Path2Parenthood's Mental Health Advisory Council and family building counselor in private practice in Newton, Massachusetts. Her special interests are in adoption, donor conception and surrogacy. A mother through adoption and birth, she is the author or co-author of six books on infertility, including most recently, Having Your Baby Through Egg Donation (co-authored with Evelina Sterling), a second edition of which will be published in May of 2013.