{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T22:34:13Z","timestamp":1791844453229,"version":"4.3.4"},"reference-count":55,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T00:00:00Z","timestamp":1740441600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000106","name":"Saskatchewan Health Research Foundation","doi-asserted-by":"publisher","award":["4577"],"award-info":[{"award-number":["4577"]}],"id":[{"id":"10.13039\/501100000106","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001804","name":"Canada Research Chairs","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100001804","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Many women struggling with infertility report that they frequently experience unhelpful social interactions with well-meaning loved ones and healthcare providers, contributing to a reluctance to confide in others about their infertility and emotional distress. However, it remains unclear what interaction content women experience as \u2018helpful\u2019 versus \u2018unhelpful,\u2019 making it difficult to provide concrete recommendations to the public about how best to support individuals struggling with infertility.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methodology<\/jats:title>\n<jats:p>Eighty women from Canada and the United States (ages 20\u201345 years) whose fertility treatments had been cancelled due to the COVID-19 pandemic were recruited via social media to complete an online survey, which included two open-ended questions about the most helpful and unhelpful social interactions they had had about their infertility. Two independent researchers conducted content analysis to identify categories of helpful and unhelpful social interactions.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The following six categories were identified by women as helpful: 1) Listening, 2) Fostering hope, 3) Talking to individuals with lived experience, 4) Distraction, 5) Validating emotions, and 6) Tangible support. Responses about unsupportive interactions fell into four categories: 1) Toxic positivity, 2) Advice-giving, 3) Invalidation, and 4) Intruding. Sample quotes from each category are provided.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>These findings provide valuable insights that can be used to develop future educational materials for the general public on how to interact with individuals experiencing infertility.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0318921","type":"journal-article","created":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T18:53:03Z","timestamp":1740509583000},"page":"e0318921","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["What women want to hear: the helpful and unhelpful comments reported by women struggling with infertility amidst the COVID-19 pandemic"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1795-8093","authenticated-orcid":true,"given":"Ashley A.","family":"Balsom","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loveness","family":"Dube","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6401-6827","authenticated-orcid":true,"given":"Jennifer L.","family":"Gordon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,2,25]]},"reference":[{"issue":"1","key":"pone.0318921.ref001","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.fertnstert.2012.09.023","article-title":"Definitions of infertility and recurrent pregnancy loss: a committee opinion","volume":"99","author":"American Society for Reproductive Medicine","year":"2013","journal-title":"Fertil Steril"},{"issue":"2","key":"pone.0318921.ref002","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1093\/humrep\/des402","article-title":"Fertility knowledge and beliefs about fertility treatment: findings from the International Fertility Decision-making Study","volume":"28","author":"L Bunting","year":"2013","journal-title":"Hum Reprod"},{"issue":"8","key":"pone.0318921.ref003","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1080\/10410230903265920","article-title":"\u201cNobody thinks twice about asking\u201d: women with a fertility problem and requests for information","volume":"24","author":"JJ Bute","year":"2009","journal-title":"Health Commun"},{"issue":"10","key":"pone.0318921.ref004","doi-asserted-by":"crossref","first-page":"2165","DOI":"10.1016\/S0277-9536(02)00221-6","article-title":"Longitudinal analyses of the relationship between unsupportive social interactions and psychological adjustment among women with fertility problems","volume":"56","author":"EJ Mindes","year":"2003","journal-title":"Soc Sci Med"},{"key":"pone.0318921.ref005","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.socscimed.2015.11.002","article-title":"An internet forum analysis of stigma power perceptions among women seeking fertility treatment in the United States","volume":"147","author":"NA Jansen","year":"2015","journal-title":"Soc Sci Med"},{"issue":"2","key":"pone.0318921.ref006","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.ejogrb.2011.04.032","article-title":"Prevalence and incidence of depressive and anxious symptoms in couples undergoing assisted reproductive treatment in an Italian infertility department","volume":"158","author":"F Chiaffarino","year":"2011","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"12","key":"pone.0318921.ref007","doi-asserted-by":"crossref","first-page":"2737","DOI":"10.1093\/humrep\/den326","article-title":"Infertile Japanese women\u2019s perception of positive and negative social interactions within their social networks","volume":"23","author":"Y Akizuki","year":"2008","journal-title":"Hum Reprod"},{"key":"pone.0318921.ref008","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.rbms.2018.10.016","article-title":"Infertility patients\u2019 need and preferences for online peer support","volume":"6","author":"PH Grunberg","year":"2018","journal-title":"Reprod Biomed Soc Online"},{"issue":"5","key":"pone.0318921.ref009","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1080\/02646838.2016.1213378","article-title":"Communicating social support online: a new classification dichotomy for exploring coping in interaction concerning infertility","volume":"34","author":"A Berry","year":"2016","journal-title":"J Reproductive Infant Psychology"},{"issue":"1","key":"pone.0318921.ref010","first-page":"1","article-title":"Infertility and childlessness: a qualitative study of the experiences of infertile couples in Northern Ghana","volume":"13","author":"P-N Tabong","year":"2013","journal-title":"BMC Pregnancy and Childbirth"},{"issue":"1","key":"pone.0318921.ref011","doi-asserted-by":"crossref","first-page":"18","DOI":"10.17730\/humo.46.1.g523641w1020073k","article-title":"Cultural Notions of Fertility in South Asia and Their Impact on Sri Lankan Family Planning Practices","volume":"46","author":"M Nichter","year":"1987","journal-title":"Human Organization"},{"issue":"1","key":"pone.0318921.ref012","doi-asserted-by":"crossref","first-page":"e0211634","DOI":"10.1371\/journal.pone.0211634","article-title":"\u201cWe are always desperate and will try anything to conceive\u201d: The convoluted and dynamic process of health seeking among women with infertility in the West Coast Region of The Gambia","volume":"14","author":"S Dierickx","year":"2019","journal-title":"PLoS One"},{"key":"pone.0318921.ref013","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1023\/A:1026280017092","article-title":"Infertility and adjustment in women: The effects of attachment style and social support","volume":"6","author":"M Amir","year":"1999","journal-title":"J Clin Psychol Med Settings"},{"issue":"2","key":"pone.0318921.ref014","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1080\/00222216.2008.11950138","article-title":"Friendships Developed Subsequent to a Stressful Life Event: The Interplay of Leisure, Social Capital, and Health","volume":"40","author":"TD Glover","year":"2008","journal-title":"J Leisure Research"},{"issue":"2","key":"pone.0318921.ref015","first-page":"91","article-title":"Investigation of social capital and its relationship with emotional adjustment in infertile couples: A cross-sectional study","volume":"20","author":"Z Hamzehgardeshi","year":"2022","journal-title":"Int J Reprod Biomed"},{"key":"pone.0318921.ref016","first-page":"384","article-title":"An assessment of the coping strategies to address infertility among couples in Kisumu County, Kenya","volume":"34","author":"A Odek","year":"2021","journal-title":"African J Health Sci"},{"key":"pone.0318921.ref017","doi-asserted-by":"crossref","first-page":"2779","DOI":"10.3389\/fpsyg.2019.02779","article-title":"Supportive social interactions in infertility treatment decrease cortisol levels: experimental study report","volume":"10","author":"A Malina","year":"2019","journal-title":"Front Psychol"},{"issue":"11","key":"pone.0318921.ref018","doi-asserted-by":"crossref","first-page":"e050373","DOI":"10.1136\/bmjopen-2021-050373","article-title":"Infertility-related distress and clinical targets for psychotherapy: a qualitative study","volume":"11","author":"L Dube","year":"2021","journal-title":"BMJ Open"},{"issue":"9","key":"pone.0318921.ref019","first-page":"e29763","article-title":"A Qualitative exploration of social support in males and females experiencing issues with infertility","volume":"14","author":"M Borowczak","year":"2022","journal-title":"Cureus"},{"key":"pone.0318921.ref020","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1037\/10360-009","volume-title":"The psychology of couples and illness: Theory, research, & practice","author":"LA Pasch","year":"2000"},{"key":"pone.0318921.ref021","unstructured":"American Society of Reproductive Medicine. Patient Management and Clinical Recommendations during the Coronavirus (COVID-19) Pandemic; 2020. Available from: https:\/\/www.asrm.org\/news-andpublications\/covid-19\/"},{"key":"pone.0318921.ref022","unstructured":"Canadian Fertility and Andrology Society. CFAS Communication on COVID-19; 2020. Available from: https:\/\/cfas.ca\/CFAS_Communication_on_COVID-19.html#march18"},{"issue":"9","key":"pone.0318921.ref023","doi-asserted-by":"crossref","first-page":"e0239253","DOI":"10.1371\/journal.pone.0239253","article-title":"The psychological impact of fertility treatment suspensions during the COVID-19 pandemic","volume":"15","author":"JL Gordon","year":"2020","journal-title":"PLoS One"},{"issue":"03","key":"pone.0318921.ref024","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1142\/S2661318221500080","article-title":"COVID-19 pandemic impacts decision-making and psychosocial behavior in women seeking fertility treatment in APAC\u2014an ASPIRE patient experience report","volume":"03","author":"B Wiweko","year":"2021","journal-title":"FandR"},{"issue":"2","key":"pone.0318921.ref025","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1007\/s10815-020-02023-x","article-title":"Psychological distress and postponed fertility care during the COVID-19 pandemic","volume":"38","author":"AK Lawson","year":"2021","journal-title":"J Assist Reprod Genet"},{"issue":"4","key":"pone.0318921.ref026","doi-asserted-by":"crossref","first-page":"317","DOI":"10.4103\/jhrs.JHRS_144_20","article-title":"Emotional impact of delay in fertility treatment due to COVID-19 pandemic","volume":"13","author":"H Kaur","year":"2020","journal-title":"J Hum Reprod Sci"},{"issue":"2","key":"pone.0318921.ref027","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1080\/13548506.2021.1922721","article-title":"The emotional impact of the Covid-19 pandemic in women facing infertility","volume":"27","author":"A Galhardo","year":"2022","journal-title":"Psychol Health Med"},{"issue":"4","key":"pone.0318921.ref028","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1362\/146934703771910080","article-title":"An overview of content analysis","volume":"3","author":"TG Harwood","year":"2003","journal-title":"Mark Rev"},{"issue":"8","key":"pone.0318921.ref029","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1016\/S2215-0366(20)30191-7","article-title":"Identifying outcomes for depression that matter to patients, informal caregivers, and health-care professionals: qualitative content analysis of a large international online survey","volume":"7","author":"A Chevance","year":"2020","journal-title":"Lancet Psychiatry"},{"issue":"1","key":"pone.0318921.ref030","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1111\/phn.13143","article-title":"Filipinos\u2019 COVID-19 vaccine hesitancy comments in TikTok videos: A manifest content analysis","volume":"40","author":"DJE Berdida","year":"2023","journal-title":"Public Health Nurs"},{"key":"pone.0318921.ref031","first-page":"1269","volume-title":"Lessons Learned from the COVID-19 Outbreak as Experienced by ICU Nurses: Manifest Qualitative Content Analysis","author":"H Alharthi","year":"2023"},{"key":"pone.0318921.ref032","article-title":"Open-Ended Questions","volume-title":"GESIS Survey Guidelines","author":"C Z\u00fcll","year":"2016"},{"issue":"4","key":"pone.0318921.ref033","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1080\/02646838.2019.1578867","article-title":"Subjective well-being of women at the beginning of fertility treatment: the role of medical variables, attachment orientation and supportive relationship with the mother","volume":"37","author":"SB Shlomo","year":"2019","journal-title":"J Reprod Infant Psychol"},{"issue":"3","key":"pone.0318921.ref034","first-page":"201","article-title":"Infertility: association with common mental disorders and the role of social support. Rev Psiquiatr Rio Gd Sul.","volume":"30","author":"MD Cunha","year":"2008"},{"issue":"3","key":"pone.0318921.ref035","first-page":"143","article-title":"Social support and quality of life in the HIV infection","volume":"30","author":"E Remor","year":"2002","journal-title":"Aten Primaria"},{"issue":"6","key":"pone.0318921.ref036","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/j.jbspin.2015.02.019","article-title":"The impact of chronic low back pain is partly related to loss of social role: A qualitative study","volume":"82","author":"F Bailly","year":"2015","journal-title":"Joint Bone Spine"},{"issue":"2","key":"pone.0318921.ref037","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1037\/0278-6133.15.2.135","article-title":"Social support and adjustment to cancer: reconciling descriptive, correlational, and intervention research","volume":"15","author":"VS Helgeson","year":"1999","journal-title":"Health Psychol"},{"key":"pone.0318921.ref038","first-page":"26","article-title":"The effectiveness of social support attempts in intimate relationships","author":"C Rini","year":"2010","journal-title":"Support Process Intim Relatsh"},{"issue":"5","key":"pone.0318921.ref039","doi-asserted-by":"crossref","first-page":"966","DOI":"10.3102\/0034654317723305","article-title":"Effective dementia education and training for the health and social care workforce: A systematic review of the literature","volume":"87","author":"CA Surr","year":"2017","journal-title":"Rev Educ Res"},{"key":"pone.0318921.ref040","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.maturitas.2015.12.008","article-title":"A systematic review of social support interventions for caregivers of people with dementia: Are they doing what they promise?","volume":"85","author":"AEH Dam","year":"2016","journal-title":"Maturitas"},{"issue":"1","key":"pone.0318921.ref041","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/S0015-0282(16)54787-6","article-title":"Psychosocial, treatment, and demographic predictors of the stress associated with infertility**Supported by grant RO1 HD 21240 from the National Institute of Child Health and Human Development, Bethesda, Maryland","volume":"57","author":"A Abbey","year":"1992","journal-title":"Fertil Steril"},{"key":"pone.0318921.ref042","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.ejogrb.2016.02.034","article-title":"The relations between marital quality, social support, social acceptance and coping strategies among the infertile Iranian couples","volume":"200","author":"F Yazdani","year":"2016","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"2","key":"pone.0318921.ref043","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.psychres.2013.10.032","article-title":"Resilience and social support promote posttraumatic growth of women with infertility: the mediating role of positive coping","volume":"215","author":"Y Yu","year":"2014","journal-title":"Psychiatry Res"},{"issue":"7","key":"pone.0318921.ref044","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1093\/humrep\/dev093","article-title":"Disclosure strategies, social support, and quality of life in infertile women","volume":"30","author":"KR Steuber","year":"2015","journal-title":"Hum Reprod"},{"issue":"1","key":"pone.0318921.ref045","doi-asserted-by":"crossref","first-page":"100015","DOI":"10.1016\/j.acorp.2022.100015","article-title":"\u2018You got this!\u2019: A critical discourse analysis of toxic positivity as a discursive construct on Facebook","volume":"2","author":"M Lecompte-Van Poucke","year":"2022","journal-title":"Applied Corpus Linguistics"},{"issue":"1","key":"pone.0318921.ref046","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1007\/s00737-020-01029-9","article-title":"Psychological coping strategies associated with improved mental health in the context of infertility","volume":"24","author":"A Chernoff","year":"2021","journal-title":"Arch Womens Ment Health"},{"key":"pone.0318921.ref047","first-page":"43","volume-title":"Reprod Health","author":"AA Balsom","year":"2024"},{"issue":"3","key":"pone.0318921.ref048","first-page":"243","article-title":"Psychosocial problems and coping strategies among Turkish Women with infertility","volume":"9","author":"A Karaca","year":"2015","journal-title":"Asian Nurs Res (Korean Soc Nurs Sci)"},{"issue":"3","key":"pone.0318921.ref049","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1002\/pon.3420","article-title":"Changes in psychological adjustment over the course of treatment for breast cancer: the predictive role of social sharing and social support","volume":"23","author":"D Boinon","year":"2014","journal-title":"Psychooncology"},{"issue":"11","key":"pone.0318921.ref050","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1177\/1049732315612044","article-title":"Shared illness and social support within two HIV-affected African American communities","volume":"26","author":"KE Mosack","year":"2016","journal-title":"Qual Health Res"},{"issue":"6","key":"pone.0318921.ref051","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1177\/1948550613479807","article-title":"The power of shared experience: Simultaneous observation with similar others facilitates social learning","volume":"4","author":"G Shteynberg","year":"2013","journal-title":"Social Psychol Personality Sci"},{"issue":"3","key":"pone.0318921.ref052","first-page":"123","article-title":"Shared social identity and perceived social support among stroke groups during the COVID\u201019 pandemic: Relationship with psychosocial health","volume":"15","author":"RA Lamont","year":"2022","journal-title":"Appl Psychol Health Well-Being"},{"issue":"1","key":"pone.0318921.ref053","doi-asserted-by":"crossref","first-page":"2378330","DOI":"10.1080\/0167482X.2024.2378330","article-title":"Testing the efficacy of a narrative short film in educating the public about providing emotional support to individuals with fertility problems","volume":"45","author":"MJ Kiviharju","year":"2024","journal-title":"J Psychosom Obstet Gynaecol"},{"issue":"18","key":"pone.0318921.ref054","doi-asserted-by":"crossref","first-page":"4579","DOI":"10.1002\/cncr.26649","article-title":"Racial, socioeconomic, and demographic disparities in access to fertility preservation in young women diagnosed with cancer","volume":"118","author":"JM Letourneau","year":"2012","journal-title":"Cancer"},{"issue":"4","key":"pone.0318921.ref055","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1016\/j.fertnstert.2005.07.1338","article-title":"Socioeconomic and racial disparities among infertility patients seeking care","volume":"85","author":"T Jain","year":"2006","journal-title":"Fertil Steril"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0318921","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T18:53:21Z","timestamp":1740509601000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0318921"}},"subtitle":[],"editor":[{"given":"Narcyz","family":"Ghinea","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,2,25]]},"references-count":55,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2,25]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0318921","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,25]]}}}