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It is estimated that one in seven couples in the UK will experience difficulties conceiving, and many will go on to have fertility treatment. The Human Fertilisation and Embryology Authority (HFEA) reports that more than 1.3m IVF cycles have been performed in the UK since 1991. I was 32 when I first underwent treatment, and I didn’t know anyone else who had been through it. Six years on, a quick headcount of IVF-enduring friends almost reaches double figures; we can no longer consider it rare. If you have friends, family or colleagues in their 30s and 40s, it is highly likely that some will be having IVF (that is not to say that no one younger will be – it is just statistically less likely: the average age is now 36).
It can be difficult to know what to say to someone who has shared that this is their path to potential parenthood – the outcome possibly exciting, possibly heartbreaking. From my experience of that challenging time, there are comments that can boost and others that, however well intentioned, can sting.
Despite having been on the rollercoaster myself, I have still walked away from conversations with friends regretting my choice of words. I think openness is always the best option; if something slips out that your brain later berates you for, then be honest and share your regret. The self-reflection shows that you care how your words are being received, and that you are trying, which is all that can be asked. Otherwise, this would be my advice:
What not to say
Oh, you’re not drinking?
The question may seem innocuous, but it is often accompanied by a raised eyebrow, a smug smile or, God forbid, a wink. Most people do not drink alcohol during fertility treatment and acting as if you have just guessed their pregnancy secret will only highlight how upsettingly untrue this is.
Children are overrated anyway
The only person allowed to say this is your fabulous child-free-by-choice friend who drinks champagne in sequined outfits while browsing art galleries each weekend, and genuinely doesn’t understand all the fuss. Mothers of three who later that day post gushing photos of their children on Instagram should categorically not say this.
Why don’t you just adopt?
Adoption is an incredible thing to do, but it is a very different route to having a family, and a complex process to navigate. When my second cycle of IVF failed, I stayed up drinking red wine and scrolling Instagram for adoption stories through intermittent bouts of tears; they brought me much more comfort than the 1.1m IVF success hashtags. But this was in the private world of my phone; if a friend had suggested I “just adopt”, I would have taken it to mean they thought my pursuit of fertility treatment was foolish and futile. Most people going through IVF will have thoroughly considered all routes to parenthood and suggesting they adopt is unlikely to be enlightening. Rather, it comes across as unsupportive.
Who has the issue, then, you or him?
I won’t gratify this with an explanation, but yes, people honestly ask this.
How exciting!
This is a difficult one. It is entirely reasonable to feel excited by the thought of your friend becoming pregnant but, for reasons of self-preservation, they will probably be approaching the process cautiously. On average, only 31% of embryo transfers are successful, so there is a careful balance to be had in terms of positive thinking and cautious restraint. I had people clapping with excitement and even congratulating me for starting the process, then telling me I shouldn’t think that way if I reminded them of the potential for failure. This sort of toxic positivity left me feeling distanced from the friends who didn’t seem to understand my hesitancy towards hope.
Well, you never know! Any holidays coming up?
Everyone has heard of a couple who had eight rounds of IVF then magically got knocked up on holiday because they “just relaxed!” This phrase has become so reviled by those trying to conceive that the Big Fat Negative Podcast now sells T-shirts emblazoned with the words. There are myriad reasons why people cannot conceive, and suggesting that lying on a beach might assuage their neuroticism is unlikely to go down well.
Did you find the donor online? Like shopping! Is there a photo? What nationality are they?
Some people going through IVF will use donors, and obviously all same-sex couples will. I asked two of my gay friends for their input when writing this article; I wanted to know if things had landed in the same way – perhaps approaching IVF without years of disappointment already stacked up meant that it really was exciting. But their views reflected my own, with an additional gripe of being asked inappropriately intimate questions about the donors. People are seemingly obsessed with the donor’s looks and nationality, asked outright which partner’s egg/sperm was being used, and frequently referred to the donors as the mother or father. These are extremely intrusive questions and not appropriate for casual pub conversations with a friend you see once a year.
What to say
I’m sorry you’re having to go through this
Reserved for heterosexual couples where there is obviously a more fun route to the end goal, sometimes a simple acknowledgment that it is not an ideal situation is all that’s needed. Just ensure you don’t slide from empathetic into dramatic pity. I’ve seen that face and all it does is scream: “Oh wow, your life sucks!”
I’m here for you if there’s anything you need
It might be offering fridge space to make room for their extensive stash of medication, driving them to a clinic appointment, or posting Hobnobs through the letterbox on a day when they are not up for company. Reminding friends that you are there and ready to show up goes further than you think.
I don’t really know much about it
Read the room on this one: if someone is telling you through tears that they are starting IVF, then now is not the time for a science lesson – go and do some background reading instead. But I didn’t expect friends to know the ins and outs of the process and always appreciated their honesty in telling me so.
I’ll get this
There is no getting away from it: IVF is expensive. NHS funding varies considerably across the UK: the latest figures show that only 24% of cycles in England were NHS-funded, whereas 58% were in Scotland. A single cycle costs about £5,000, and most people will require multiple. People take on second jobs and remortgage their houses to fund treatment. It can be incredibly stressful, so don’t make them feel bad if they skip that absurdly priced hen do or suggest dinner at a place with buy one, get one free burgers. Paying the bill for their beetroot smoothie might feel like a drop in the ocean, but it is a kindness that will be noted.
Nothing
My best friend left a bottle of non-alcoholic wine on our kitchen table with a hand-drawn card of a pineapple, the words “still ’ere” carefully inked beneath. A colleague put a card in my tray after I asked my manager to let her know I was starting treatment. We never talked about it, but I read her kind words again and again. When I mentioned that the hormones were making me feel exceptionally blue, my schoolfriends, hundreds of miles away, banded together and sent flowers. Sometimes, caring from a distance can feel less confronting and more powerful.
I know someone else going through it, if you ever wanted to talk
Many people don’t know anyone else going through IVF, so if you can connect two willing people, then do. There is a whole sisterhood of big-hearted, needle-wielding warriors out there and, while comparisons can feel dangerous (how many eggs, what grade of embryos etc), with some care and boundary-setting, these obstacles can be navigated and the benefits reaped. My sister-in-law ended up going through three rounds at a similar time to me. We messaged regularly, about optimal needle insertion angles or the pros of nettle tea, or how we weren’t sure how many times we could do this. She was the first person I told when I got two blue lines, even before my husband. Our sons were born two weeks apart.
