When someone you love is struggling with infertility, it's not uncommon to wonder what you should do or say to be helpful -- and not hurtful. A lot of the anguish expressed by my fertility-challenged patients stems from well-intentioned comments made by family members and friends. I would like to believe that these comments are truly well-meaning (this comes from what my husband calls my pathological level of optimism), but they're not always interpreted as such by the individual or couple on the receiving end who is desperate to start a family. So if you'd like to be a positive force, here's a general list of do's and don'ts to help you navigate this emotional minefield.

Mum's the word. If you have a friend, family member, or co-worker who has confided in you that she is struggling with infertility, take that confidence seriously. About half of all infertile individuals keep the information private out of a sense of guilt, shame, or fear. So if someone has told you that this is a problem for her, feel honored. And do not, for any reason, share the information with anyone else.

Leave it to the experts. Support your loved one in her treatment decisions, but don't give medical advice. I know that those of us who read People magazine cover to cover every week have a lot of know-how about infertility treatment and its success, but be aware that if your friend or family member is seeing a physician who is an expert in infertility, there is a fairly good chance that doctor knows more about her case and the appropriate course of treatment than you do. If you happen to know someone else who has an infertility doctor that she loves and has been successful with, you can offer the physician's name and contact information, but leave it at that.

Don't take it personally. Individuals and couples who are experiencing infertility tend to feel uncomfortable, and even saddened, by pregnancy announcements, the presence of a pregnant woman, baby showers, newborns, and baby/child birthday parties. This is a completely normal reaction to infertility and it does not mean that your sister/friend/cousin is a selfish b!tch. It simply means that being dramatically reminded of what she wants more than anything in the world -- but hasn't achieved yet -- can be too painful to bear.

Break it gently. Since pregnancy announcements can be particularly excruciating, be sensitive to this. If you have your own happy news and want to let her know, do not subject her to a public pregnancy announcement. Simply call her when you know she is not home or email her and tell her that you are expecting. Mention that you promise not to bombard her with details unless she asks. And, as odd as this might sound, don't be surprised if her jealousy of your success is too much for her. Just know that deep down she is likely very happy for you, since she would not wish infertility on anyone.

Easy does it. Continue to treat her the same as your other friends in terms of inviting her to your shower and letting her know when your baby arrives, but don't email her the prenatal ultrasounds, don't call her with the gory details of your morning sickness, and do not feel offended in any way if she declines to attend your shower or come visit you in the hospital. She is simply struggling with an extremely difficult life crisis and is trying to minimize her agony.

It's also helpful to read up on the basics of infertility; www.Resolve.org and www.asrm.org are good places to start. If you can understand what your loved one is going through and can ask intelligent questions, it will help her. More important than anything else, simply tell her that you love her and ask her to be really specific about what she needs from you. Do what she asks, where possible, and don't feel badly that you can't do more. If you're smart, sensitive, and thoughtful in your approach, you can take heart that you're helping as much as anyone can during a difficult time.