Understanding the Hardships of Fertility / IVF Treatment: A Guide for Family and Friends

     Photo by Vonecia Carswell on Unsplash

Supporting a loved one undergoing fertility treatment can be challenging, especially when you’re not fully aware of what they’re experiencing. Here are some key points to help you understand why this journey can be so difficult and some suggestions for how to best support them –

Emotional, Mental, and Physical Toll: The constant stress, emotional ups and downs, and physical discomforts occur for most people throughout almost every part of the process.

Mental Wellness: Sometimes, individuals have to stop treatments for their mental health, which can feel like giving up.

  • Example: They may decide to pause treatment due to anxiety, depression or other mental health challenges.
  • Suggestion: Support their decision without judgment and without offering unsolicited advice. Encourage them to prioritize their mental health and seek professional help if needed.

Constant Anxiety: Even when treatments are successful, the anxiety doesn’t simply disappear. It’s not uncommon for the anxiety to compound.

  • Example: After a positive pregnancy test, they might worry about the viability of the pregnancy.
  • Suggestion: Offer reassurance and remind them to take things one step at a time. Be there to discuss their fears without pushing them to be overly positive.

Uncertainty: The unpredictable nature of treatment outcomes is confusing and painful, leaving people feeling less in control of many parts of their lives.

  • Example: They might feel stressed about the outcome of each treatment cycle.
  • Suggestion: Offer to help them find small ways to regain control, such as planning enjoyable activities or maintaining routines outside of treatment. Respect their decision to take your offer or not to without pushing them, since this can duplicate their feelings of having little control.

No Control: The feeling of having no control over the process or outcomes is incredibly challenging.

  • Example: They might express frustration about not being able to influence the success of treatments.
  • Suggestion: Validate their feelings and avoid giving unsolicited advice. Offer to help with things they can control, like daily tasks or self-care routines. You can offer to do some of these with them, such as meditation or a mindful walk.

Physical Pain: Some procedures can be excruciatingly painful.

  • Example: Egg retrieval or hormone injections might cause significant discomfort.
  • Suggestion: Offer practical support, such as preparing meals, running errands, or simply being there to provide comfort.

Self-Administered Injections: The daily challenge of giving oneself hormone shots is neither pleasant nor easy.

  • Example: They may feel bloated, moody, or experience pain from injections.
  • Suggestion: Offer to assist with injections or provide moral support during this time.

Comparisons: The difficulty of comparing one’s journey to others’.

  • Example: Seeing friends get pregnant easily might trigger feelings of jealousy and despair.
  • Suggestion: Encourage them to focus on their own journey and achievements. Remind them that everyone’s path is different. Validate their decision if the opt out of baby showers or other such events that may feel triggering for them.

Seeing Others Struggle: Moving forward in their journey while others they know are still struggling to become pregnant can also be emotionally complex.

  • Example: They might feel guilty for progressing while friends remain childless.
  • Suggestion: Encourage open discussions about these feelings and reassure them that it’s human have mixed emotions.

Extended Timelines: The prolonged duration of treatments, even when things go according to plan.

  • Example: A single IVF cycle can take several months.
  • Suggestion: Help them find patience by planning enjoyable distractions and celebrating small milestones along the way.

Miscarriage: The heartbreak of losing a pregnancy after so much effort and hope.

  • Example: They might grieve deeply after a miscarriage, regardless of how far along they were.
  • Suggestion: Acknowledge their loss and provide a supportive presence. Avoid trying to “fix” their grief.

Loss of Optimism: As the fertility journey lengthens, the belief that good things can happen for them often decreases.

  • Example: They may become increasingly pessimistic about the chances of success.
  • Suggestion: Be a steady source of support without forcing positivity. Allow them to express their feelings and be there for them in their dark moments.

Self-Imposed Pressure: The immense pressure individuals place on themselves to succeed is immeasurable.

  • Example: They might blame themselves for failed treatments.
  • Suggestion: Remind them that infertility is not their fault. Offer compassion and avoid any language that could imply blame.

Financial Strain: The high costs of treatments can be a significant burden.

  • Example: Treatments can cost tens of thousands of dollars, often not covered by insurance.
  • Suggestion: If possible, help them find financial resources or support. Acknowledge the financial stress and offer emotional support.

The Two-Week Wait (TWW): The agonizing period between embryo transfer and the pregnancy test.

  • Example: They might overanalyze every physical sensation during this time.
  • Suggestion: Distract them with activities and be patient with their anxiety. Reassure them that their feelings are valid.

Withdrawals: The physical and emotional toll of stopping medications after a failed cycle.

  • Example: They might experience mood swings and physical discomfort when stopping medications.
  • Suggestion: Be understanding and supportive. Offer to help with daily tasks as they navigate this challenging period.

Explanation Fatigue: Exhaustion from having to explain to friends and family updates about the cycle.

  • Example: They might feel drained from constantly updating others about their progress.
  • Suggestion: Offer to be the point person to share updates with others, if they are comfortable with it.

Unexplained Failed Transfers: The disappointment of embryos not implanting should have its own name, as it is one of the biggest challenges of the IVF process and often has no explanation.

  • Example: After all the effort, a seemingly perfect embryo might not implant.
  • Suggestion: Validate their disappointment and grief. Avoid offering explanations or false hope.

Coming Home Empty-Handed: The pain of returning home without a positive result after so much hope and effort.

    • Example: They might feel devastated after a failed cycle or miscarriage.
    • Suggestion: Provide a comforting presence and avoid minimizing their pain. Allow them to grieve. Let them lead regarding talking about their feelings and what they need.

Nothing is Guaranteed: Despite the effort, there is no certainty of success.

  • Example: They might struggle with the uncertainty and potential for an unsuccessful outcome.
  • Suggestion: Offer unwavering support and remind them that their worth is not defined by the outcome. Validate how hard it is to have so little control over so many variables.

Ignorant Comments: Insensitive remarks from people who don’t understand the process.

  • Example: Comments like “Just relax, and it will happen” can be hurtful (and not necessarily true).
  • Suggestion: Help them prepare scripted responses to such comments and offer to intervene if needed.


  • Spontaneity: The need to schedule and plan everything.
    • Example: They might have to plan their lives around treatment schedules.
    • Suggestion: Help them find small ways to add spontaneity back into their lives.
  • Privacy: The intrusion into personal and intimate aspects of life.
    • Example: Frequent medical appointments and procedures can feel invasive.
    • Suggestion: Respect their need for privacy and avoid prying into details unless they volunteer them.
  • Fun in Intimacy: The joy and fun of sex can diminish.
    • Example: Sex might become a clinical necessity rather than an intimate act.
    • Suggestion: Encourage them to find ways to reconnect emotionally and physically outside of the fertility context.
  • Surprise: The loss of the natural surprise element in conception.
    • Example: They might feel sadness over the loss of a spontaneous pregnancy announcement.
    • Suggestion: Acknowledge this loss and help them find joy in other surprises in life.
  • Financial Loss: The high cost of treatments can lead to debt.
    • Example: They might face significant financial strain from ongoing treatments.
    • Suggestion: Offer to help find financial support or resources. Be sensitive to their financial stress.
  • Identity and Confidence: The emotional toll can lead to low self-esteem and confidence.
    • Example: They might feel their identity is tied to their ability to conceive.
    • Suggestion: Remind them of their worth to you and other loved ones, outside of fertility. Encourage activities that boost their confidence and self-esteem.
  • Waiting Periods: The waiting in fertility treatment feels endless at every stage.
    • Example: Each step involves anxious waiting, from menstrual cycles to test results.
    • Suggestion: Be patient and offer distractions. Help them manage their anxiety during these periods.

Understanding these aspects can help you provide empathy and support to your loved one during their fertility journey. Offer your presence, patience, and understanding to help them navigate this challenging time.

Rachel Shanken, Somatic Fertility Therapist in New York City