Want to provide support but unsure how? Here, a counsellor & those who’ve been there share their recommendations for talking about it openly and sensitively

For individuals and couples struggling to get pregnant, an unwelcome side effect can be a feeling of alienation from loved ones who struggle to relate and "don’t know what to say"; say the wrong thing; or, worse still, keep their distance (usually, out of a fear of the former two).

Fertility problems can include everything from premature ovarian insufficiency (POI), which is when a person’s ovaries stop working before the age of 40, and rare genetic disorders, to male-specific problems, such as low sperm production, says Jemma Barnett, a counsellor at Care Fertility clinic in Nottingham.

These issues are common, around one in seven couples may have difficulty conceiving after having regular, unprotected sex, according to NHS data. This means if you have friends or family who are looking to have children, it’s likely that some currently fall into this category, even if you’re unaware of it.

Reach out and let them know you care

So, how can those of us on the other side support those close to us when they’re having difficulty conceiving? It starts with asking questions, says Poppy, 32, who has been trying for a baby with her husband for just over three years, with one pregnancy that ended at 20 weeks for medical reasons. "I’m always grateful when people ask me about my fertility journey as I feel like they care. It can be a lonely journey and so when someone genuinely wants to know, then I’m happy to share."

Chloe, 36, has been trying to conceive with her partner for two and a half years, with one eight-week pregnancy that ended in miscarriage. Her advice for supporting those in her situation? "Show them some love! You get endless well-wishes and check-ins when you're pregnant or you've just had a baby, but your childless friend needs to know that they are valid and deserving of your love."

It can be a lonely journey and so when someone genuinely wants to know, then I’m happy to share

This love can come in many forms – including questions about subjects unrelated to fertility: "Show interest in stuff in their lives. It always means loads to me when people ask about my dog. The same for my work," Chloe adds.

Meanwhile, while there’s no magical "right" thing to say, Jemma suggests some helpful phrases: "Do you want to talk about it?"; "I’m here to listen if you need someone"; "What do you need right now?"; "How can I help?"; "There is no right or wrong way to feel."

Try not to avoid the topic

Saying something is almost always better than nothing, so don’t avoid bringing up the topic out of discomfort, says Poppy. "Too often people avoid the topic as they feel it’s taboo or for fear of upsetting me, but personally it’s quite the opposite."

Just don’t back away from your loved one’s experiences, or overcommit and underdeliver, she adds: "I hate it when people say 'I never know what to say so I don't say anything at all...but you know that I'm here if you want to talk' and then never actively check in. Their discomfort should not be my issue to take on and feels like a cop out."

Find out what they need

The process can be an emotional rollercoaster, which may involve tense waiting periods between medical appointments and meetings with fertility specialists. So, what’s the best practice around checking in? Some, like Poppy, say they appreciate when people "ask when my next appointment is and check in for a chat afterwards," while Chloe says she appreciates the space to not talk about it: "Don't ask (the person struggling) about it all the time – it's a horrible subject, and they might not want to talk about it."

Essentially, there’s no one size fits all solution – so just ask. "Give them the permission to guide you," says Jemma. "Often patients feel under pressure when informing others of their treatment because they don’t always want to talk about it. Allow them to have control and to inform you about what’s helpful for them. For example, ask if they would like you to contact them after appointments or treatments and see how it went, and if they would, then ask them what form of contact they would prefer."

Allow them to have control and to inform you about what’s helpful for them

Avoid telling them to "just relax"

There is, however, more consensus around what not to say: "Never, ever say 'Relax, it will happen!' Trying for a baby and it not working is unbelievably stressful. Adding the pressure of relaxing about it is even worse," says Chloe. You might want to avoid offering "anecdotal evidence" (think "my neighbour was trying and then she did so-so…"). "It's not necessarily helpful, so just be careful with it," Chloe adds.

Other no-no phrases, according to Poppy, include: "It will happen when it's meant to be" or "at least you know you can get pregnant" (referring in this case to her lost pregnancy) because you really do not know these things and it often minimises someone’s experience.

Practical gestures can go a long way, for instance planning quality time together: "Organise a spa day out or a dinner together," Poppy suggests. Small gifts can also be a nice touch – Jemma recommends "Sending a card, some flowers, or a candle or trinket to say you’re thinking of them." But do be conscious "not to expect too much back from the other person", who might not currently "have the headspace to think about the needs of others," she adds.

Be mindful about sharing news

Comparison is the root of unhappiness – and never more so than when it comes to fertility struggles, says Jemma. "One of the biggest challenges for a couple is having to cope with the fact that many of their peers are having babies. Dealing with pregnancy and birth announcements or having to attend Christenings and children’s birthday parties can be so hard. (Couples) have to show happiness and joy towards others and then very often will go home feeling totally exhausted and empty."

One of the biggest challenges for a couple is having to cope with the fact that many of their peers are having babies

A particularly triggering experience can be when someone close to you falls pregnant, says Chloe – so sensitivity in communicating the news is key. "Text (the person struggling) personally if you have a pregnancy announcement – I have loads more to say about this stuff, but at a basic level, group chat announcements are hard to handle."

Poppy agrees: "I would stress texting over calling if you're announcing your own pregnancy. While they would be happy for you, it’s gut wrenchingly sad for the person going through infertility, so you should give them the time to process the information. Friends once Facetimed me to tell their good news and I had to sit there smiling until I hung up and broke down crying."

Try not to problem solve

Essentially, supporting a loved one or couple with their struggle getting pregnant means showing up courageously in order to reassure them they’re not alone in their uncertain journey. It’s simpler than you think, suggests Jemma. "Try not to problem solve. Sometimes the person struggling just needs to vent or cry and let it out, and all they really need is for their partner/person supporting them, to sit and listen and hold their hand."