What you should (and shouldn't) say to someone struggling to build a family

SEATTLE - We're tackling infertility, but we aren't just hoping to help those who struggle through it. Our hope is to educate family members, friends, even co-workers about how they can best support those who are trying to build their family.

My husband and I are the one in eight couples facing infertility, and while we aren't alone, most people don't talk about it - and when family and friends aren't quite sure what to say, it can be incredibly isolating.

Dr. Lora Shahine with Pacific NW Fertility says you don't have to have the perfect thing to say - it's having an awareness that's important.

"I think people should be pretty cautious with what they ask other people in casual conversation," she advises.

Think of the first birthday party you might attend for your friend's 1-year-old. A common question to the parents seems to be, "When are you giving little Junior a sibling?"

Many people assume that if you have one child, there must not be any struggle to have another. But Dr. Shahine says that's simply not always the case.

"What if that person had three miscarriages before this, and they're just so elated to have this baby in front of them, and they're terrified of even thinking about that?" she said.

Or, perhaps they didn't struggle to have their first child, but now that a few years have gone by they suddenly find themselves not getting pregnant. It can be incredibly difficult.

Some advice I would add based on my personal experience with both infertility and pregnancy loss: While you don't want to demand to know why a couple doesn't have kids, if you are close with them and they've shared that they've been struggling, it's OK to ask simply, "How are you?"

We don't expect anyone to know what to say - heck, we ourselves still don't know what to say. But letting someone know you're thinking about them and truly want to know how they are, gives them the space to talk about it if they want to (sometimes it feels good to be able to talk about it), and the permission to say nothing if they aren't comfortable or don't feel like it.

In a pinch, when you don't know what do say? Say THAT. "I don't know what to say."

Anything is better than silence or pretending it's not happening.

If you know someone is going through a difficult time building their family, but you aren't certain they want to talk about it, simply saying "I'm here if you ever want to talk" and leaving it at that means a lot.

Everyone is so different - for us, we were quiet about it at first and then realized it was too much pressure trying to avoid talking about the one thing taking up a majority of our lives. Once we started telling people, it was a huge relief to have people actually ask us how we were - it made us feel more human and less "special case".

Bottom line?

"Don't assume anything when you meet someone," Dr. Shahine says.

Infertility affects millions and millions of people, and it's not always who you might think.

"It can be anything from what you would consider a typical fertility patient in an older couple, where the average age of the woman might be late thirties or early forties. But there's a lot of young couples, even in their twenties, who have been struggling over a year to conceive."