Most insensitive comments aren’t meant to be hurtful. They are made out of ignorance or out of a strong desire to say something that will defuse a tense moment. After all, we want to solve our friend’s problem, heal their pain, or make light of the situation in a joking manner. Instead, we unintentionally make things worse.

Things to Avoid Saying

If you have a friend or family member with infertility, you’ll want to avoid saying these 12 things.  Already said one of them? Don’t be afraid to go back to your friend and apologize. It can become a healing moment for you both.

“You Can Always Do IVF”

IVF is often seen as a cure-all for infertility. Can’t get pregnant? Just do IVF!, people say. Except it’s not so simple. First of all, IVF is a very expensive treatment. It is rarely covered by insurance in the United States and frequently only partially covered in other countries. One treatment cycle can cost anywhere between $12,000 and $25,000. However, multiple cycles may be needed to achieve success. Couples may also need donor eggs, sperm, or embryos, or even a surrogate, which is significantly more expensive. One study found that the average cost of IVF treatment per successful birth is $61,377! It was even higher for IVF with donor eggs, at $72,642. Those high numbers are the result of multiple cycles needed for success. Secondly, IVF is not a cure-all. Even if you have the cash, IVF may not be successful. For women under 35, there’s just a 35.9% per cycle success rate. This will also vary depending on the cause of infertility. The IVF success rate for women age 41 to 42 is a low 12.6% per cycle.  Thirdly, not everyone wants to go through the IVF treatment process. It’s an invasive and emotionally intense treatment. While IVF is generally considered safe, it’s not without risks. Some have religious objections to IVF. IVF is clearly not for everyone.

“Just Adopt”

Adoption can be a wonderful option for some couples, but it’s not a decision that should be made lightly. Suggesting adoption in a flippant way ignores the financial and emotional costs of adoption. Also, adoption is not always possible. There is an application and approval process to adopt a child. Not everyone who wants to adopt will pass the screening process. (Not passing the screening process doesn’t, by the way, mean the person wouldn’t make a great parent. It’s more complicated than that.) Also, adoption doesn’t take away the pain of being unable to have a biological child. Offering the option as a comfort doesn’t usually go well. Adoption doesn’t replace having biological children, but it is another way to build a family.

“Trust Me, You’re Lucky You Don’t Have Kids”

Infertile couples aren’t clueless. Who hasn’t been seated at a restaurant next to a loud, messy family or endured a long plane ride next to a screaming baby? We all know babies cry and puke. We know children are messy and loud. We know our lives will change drastically when we have kids. Don’t downplay a couple’s situation by making your blessing sound more like a curse.

“You Need to Relax. All That Stressing Is Causing Your Infertility”

This myth is so prevalent that even some doctors repeat it, but everyday stress does not cause infertility. A large study published in BMJ looked at 3,000 women, from 10 different countries. They found that high levels of emotional distress before a treatment cycle did not negatively affect the outcome. In other words, feeling stressed out doesn’t prevent your infertile friend from getting pregnant. You may also want to consider what came first — the stress or infertility? Your fertility challenged friend probably wasn’t stressed out about getting pregnant until she discovered it wasn’t happening the way it should.

“Maybe You’re Not Meant to Be Parents”

This one really hurts. If this were true, then how can anyone explain why truly bad and even abusive parents manage to have children? Being qualified for the job is clearly not required. No one knows why bad things happen to good people. Please don’t play God by telling people why they haven’t conceived.

“But You’re so Young! You Have Plenty of Time to Get Pregnant”

Not always so. Being young doesn’t make you immune to infertility, and time is not always on your side. For example, if a woman has premature ovarian failure (also known as premature ovarian insufficiency), time is not on her side. The longer she waits, the more likely she will need an egg donor. Endometriosis is another condition that worsens with time. While being younger usually increases the chances of fertility treatment success, it doesn’t always. And being young never guarantees success.

“You Put Your Career in Front of Having a Family? Tsk, Tsk”

First of all, suggesting that infertility is someone’s fault is insensitive. Even if there may be a tad of truth in it, just don’t go there. Secondly, don’t assume someone didn’t have a child at a younger age because of career. A survey of Canadian women who had just had their first child found that less than 30% of women mentioned career goals as being an important part of their family planning. The top three factors women took into consideration before starting a family were being in a secure relationship (97%), feeling in control of their life (82%), and feeling ready to parent (77%.)

“What’s the Big Deal? You Already Have a Child”

Secondary infertility—infertility that comes after you’ve already had a child—is a big deal to the women who face it. Having a child or children doesn’t take away the pain of being unable to have more, especially if you’ve always imagined your future family being bigger. Before you tell someone to “be grateful” for what they have, don’t assume they’re not. Couples with secondary infertility really know what a blessing it is to have a child. It is possible to feel grateful for what you have and sad over what you don’t at the same time.

“So, Whose Fault Is It? His or Hers?”

Don’t assume that since someone confided in you that they’re infertile that they’re now ready or willing to share all the details. Infertility needs to be spoken about more, but it is still a personal topic. Please respect people’s privacy.

“If You Really Wanted a Baby, You’d Have One Already. Your Mind Is Probably Preventing You From Conceiving”

When someone is aching to conceive and have a child more than anything, being told they don’t want one enough is a real punch to the gut. Perhaps made popular by The Secret, there are people who truly believe you can prevent pregnancy by just “not really wanting” it to happen. Tell that to all the pregnant women who did not intend to conceive! It’s not true. Even if on some unconscious level a woman or man doesn’t want to have a child, “not wanting it enough” won’t cause infertility. If this were true, there would be no need for birth control.

“It Could Be Worse. It Could Be Cancer”

This is about as comforting as telling a friend who has just lost their father, “Well, it could be worse. Your mother and your father could have died.” Avoid acting as the compassion police, determining who deserves compassion and who doesn’t. Interestingly enough, research has found that the emotional distress experienced by women with infertility is similar to the distress experienced by cancer, HIV, and chronic pain patients.

“Whatever You Do, Don’t Give Up. It’ll Happen!”

This seems like a reassuring thing to say, but unfortunately, it isn’t. One problem with this is it makes it sound inevitable that things will work out in the end. The truth is they may not. Being told, “Don’t worry, it’ll happen,” tends to be translated internally as, “Stop complaining because it’s not a big deal anyway.” The other problem with this statement is it implies “giving up” isn’t an option. Deciding to stop treatment, or even deciding not to pursue treatments at all, is sometimes exactly what a couple wants or needs to do. If you want to be supportive of a friend with infertility, educate yourself. And, keep in mind, it’s often helpful to do more listening than speaking.