It may surprise you to know that one out of six women who wants to have a baby cannot conceive. There are many possible reasons for this dismal statistic: blocked fallopian tubes, ovarian failure, hormonal imbalances, toxic exposure, husband's low sperm count, to name just a few. Moreover, after a woman turns 35, it becomes difficult to have a baby primarily because many of the eggs she has left are defective.

All these barriers to pregnancy are physical or physiological, not psychological. Tubes don't become blocked because a woman is "trying too hard" to get pregnant. Antibodies that kill sperm will not disappear if a woman simply relaxes. And a man cannot make his sperm swim faster by developing a more optimistic outlook.

WELL-MEANING ADVICE

It's easy to want to give advice and help when someone womeone we care about has a problem. If there's nothing specific that we can do, we try to give helpful advice. Often, we draw on our personal experiences or on anecdotes involving other people we know. Perhaps you recall a friend who had trouble getting pregnant until she and her husband went to a tropical island. So you suggest that the person you care about and her husband take a vacation, too.

They may appreciate your advice, but she cannot use it because of the physical nature of her problem. Not only can't she use your advice, the sound of it upsets her greatly. Indeed, she's probably inundated with this sort of advice at every turn. Imagine how frustrating it must be for her to hear about other couples who "magically" become pregnant during a vacation simply by making love.

When you're undergoing infertility treatment, making love and conceiving a child have very little to do with one another, now. It's impossible to imagine how hard she's been trying to have this baby and how crushed she feels every month she learns that she's failed again. Your well-meaning advice is an attempt to transform an extremely complicated predicament into a simplistic little problem. By simplifying her problem in this manner, you've diminished the validity of her emotions, making her feel psychologically undervalued. Naturally, she will feel angry and upset with you under these circumstances.

The truth is there's practically nothing concrete you can do to help. The best help you can provide is to be understanding and supportive even when you don't understand. It's easier to be supportive if you can appreciate how being unable to have a baby can be such a devastating blow.

THE BOTTOM LINE

Because she does have fertility problems, life is extremely stressful. Simple things like baby showers, pregnant friends and coworkers, movies with babies, etc. They can all be stressful. Seldom are we (the infertile) so jealous that we wish someone else wasn't pregnant. But the joy is ALWAYS bittersweet. Cause it hasn't happened for us. Usually we are doing our best to cope. Somedays and months will be easier than others. Please try to be understanding. Sometimes she will be depressed. Sometimes she will be angry. Sometimes she will be physically and emotionally exhausted. She's not going to be the same old person she used to be to all times. She won't want to do many of the things she used to do.

She has no idea when, or if, her problem will be solved. She's engaged in an emotionally and financially taxing venture with a low probability of success. Overall, only about 20 percent or so of those people using special fertility treatments succeed in having a baby. The odds are even lower for women over 40. The longer she perseveres, however, the greater her chances of pregnancy become. Maybe someday she will be successful. Maybe someday she will give up and turn to adoption, or come to terms with living a childless life.

At present, though, she has no idea what will happen. It's all she can do to keep going from one day to the next. She does not know why this is her lot. Nobody does. All she knows is the horrible anguish that she lives with every day.

Please care about her. Please be sensitive to her situation. Give her your support, she needs it and wants it.

But please don't be insensitive. Think before you say something. Those little comments will always be remember. Always.