For many of us, the word "holiday" is synonymous with "family." And in our culture, that usually means kids, talk of kids and anticipation about having kids. Family gatherings, large and small, include speculation about babies: who's pregnant or whose "turn" it is to get pregnant. With this kind of pressure, it's easy for the infertile couple to feel isolated.

Those with children, or who have no difficulty having them, sometimes have a hard time understanding how difficult family holidays can be when someone is struggling with infertility. Rhonda, of Mt. Gilead, Ohio, is not looking forward to family holiday gatherings, particularly because a close cousin is pregnant and due in the spring of 2000. "This is especially difficult because we are always being compared. Whenever the family is together, it is difficult to hear questions of 'when are you going to have a baby; Michelle is having one.'" Most of Rhonda's family does not know that she and her husband are having difficulty conceiving, and she doesn't feel supported by those who do know.

For Missy, thinking positive is essential to getting through the holidays. "My husband and I cope during the holidays by maintaining our positive attitude. When we see pictures, commercials or children in the mall we just keep telling each other that that will be us very soon and then imagine the holidays with kids running around. As much as we desire and long for children, we have come to enjoy this time together as a couple and realize how much time we have for ourselves right now."

Missy is very fortunate that family are supportive and positive about she and her husband's infertility treatment, and yet allow the couple their privacy. "As for well-meaning friends and families, we have told everyone that we are undergoing infertility treatments and since doing so, it has eased the pressure of relatives questioning our pregnancy plans. Our families have adopted an 'If Missy and Derek want to talk they will bring it up, if not, do not hound them' attitude. This has worked rather well and has enabled us to do tests in peace. Then, when WE are ready to talk for support, encouragement or what have you, we do."

For others, it is more difficult to remain positive throughout the holiday season. Laura, of Kissimmee, Fla., has been trying to have a baby since she was married nearly 7 years ago. "I get really depressed because Christmas is such a special holiday, and being brought up in a big family, I just assumed I would have one too. It has made me feel like less of a woman because I am the oldest of all my cousins and the only one without children." Laura added, "It is very hard; the holidays are a time for togetherness and with that comes what every woman dreams of: a family of her own to share things with, and a legacy to leave behind."

Suzy, of Missoula, Mont., echoes Laura's sentiments. "To me, holidays are all about establishing family traditions. As an infertile couple, we see year after year go by doing things that are half what his family did, half what my family did, and not really feeling part of either. We want so much to be able to start creating our own traditions that we or our kids make up along the way. It's what makes holidays special."

According to Psychologist Mary Casey Jacob, PhD, of the University of Connecticut's infertility program, who has been counseling infertile couples for ten years, traditions are important, but Dr. Casey also feels strongly about defining family. "You and your partner, who have made a commitment to have a life together, are a family. It's OK for your family to start traditions even if you don't have children. People without children don't always feel they have that right."

Well-meaning family members who know that a couple is having trouble conceiving or in treatment for infertility can unthinkingly rub salt in the wound by asking questions and focusing on a couple's infertility. Dr. Casey advises couples to be frank about how they feel. "Infertile couples sometimes avoid certain family and friends because they ask questions that make them uncomfortable. These family members are between a rock and a hard place: should they ask, or not? Couples can say to these people, we know you're rooting for us. It's hard for us to answer questions; can we be the ones to bring it up?" Dr. Casey says that couples often feel that they have to answer these questions or be obnoxious about not answering. She suggests that couples be proactive in their dealings with family members. "Be prepared to ask others questions about themselves. People are often happy to talk about themselves."

Jackie, who lives in Israel, knows that holiday family gatherings will bring questions, both spoken and implied, about when she and her husband plan to have a child. They are currently trying to conceive but haven't shared this with family. "I guess what is most important in dealing with these unending questions, is that DH and I are in complete agreement about when to tell them, so there is no tension between the two of us. We are sure that some of our closer family suspect that we are in the process, but until we bring it up, they know that they can't ask directly. Our basic means of handling family celebrations is to find ways to keep the spotlight off of us, because we know in just a month or two we will be ready to take center stage and make our big announcement and we know that the surprise will be that much more special if we haven't given any pre-release announcements!"

Dr. Casey recognizes that at certain times during holiday celebrations, the stress may feel overwhelming. "Let people know that you may leave early. And work out signals in advance with your partner that let each other know when you're feeling overwhelmed and need to be bailed out." She suggests that couples take "legitimate breathers" such as checking on the turkey, playing basketball with teenagers in the driveway, or walking the dog.

For Suzy, the stress came not during the family celebration, but after a particularly hectic and child-centered Thanksgiving. "When my husband and I left and got in our car, the silence was deafening. It was such a blow to go home to a dark, cold, empty house. I wanted so much to have that much fun and activity in my house."

Dr. Casey emphasizes that couples who rehearse and prepare for how they'll handle such situations tend to cope better with the stresses that the holidays bring. "You know it will be tough," she notes. She suggests that couples participate in life as it is now, rather than putting it on hold until they have children. She also recommends that they plan something special for afterwards that isn't about holidays, family and children. Having something special to look forward to in January can help you cope during the holidays.

Want to see more?

• All I Want for Christmas: Coping With Infertility During the Holidays
• The Most Common Myths About Infertility
• Taking it Easy While Trying to Conceive
• Why Can't I Have a Flower on Mother's Day?
• Talk about it!