Why Asian American Women Wait Too Long to Get Fertility Help - And What You Need to Know

Asian Americans face their own set of barriers and cultural pressures when dealing with infertility, often waiting dangerously long before seeking help.

If you're an Asian American woman wondering about your fertility, dealing with family pressure about marriage and kids, or struggling to get pregnant, understanding these cultural dynamics can help you get the care you need sooner rather than later.

Why Asian Americans Wait Longer for Fertility Help

Elaine Gee-Wong, a Licensed Marriage and Family Therapist who specializes in fertility issues, sees this pattern regularly. "Asian Americans experience infertility at the same rate as other communities, and it's been shown that Asian Americans tend to wait longer before reaching out for medical help. One study showed that it's more likely that an Asian American couple will wait two years or longer before reaching out for medical help compared to a White couple."

This delay matters more than you might think. "Time and age matter so much when it comes to fertility, and waiting years to get help is too long to wait. So if Asian Americans may be more reluctant to seek out help when it comes to fertility, we need to start talking about what it even looks like to get help and when and what that looks like (i.e. guidelines for when to contact a fertility clinic, how do you find a fertility clinic, what kinds of tests are included in a fertility work up,etc). Sometimes, just knowing some more information about what's involved can help settle nerves."

The Cultural Pressure Cooker

Asian American families often have very specific expectations about success, and those expectations can create particular challenges around fertility.

"(I have to start by saying that the term 'Asian American' is so broad and encompasses so many groups of people that I can only speak very generically about Asian Americans.) When I start working with a patient, I assume that I know nothing about how they identify culturally, what their family background is, what their family's immigration story is, or what their family values are. Each family has its own particular culture, and each person has their own experience of that family culture," Gee-Wong explains.

That said, there are some common patterns: "One thing that I've seen with Asian Americans is that the parental expectation that you will be a success and bring pride to your family is high. The details and particulars of what 'success' means varies from family to family. But in general, you're considered 'successful' if you do well both academically and professionally AND have a family. Going to a good school (grad school is a plus, maybe even a given), having a good (read: high paying job with a prestigious title) job, buying a nice house are pretty much expected. You can increase the odds of these things happening by working hard. But the part about having a family is something that we don't have as much control over. Meeting the right person, figuring out how to have a functional relationship, merging households, and having a baby all before it's too late? Many things need to line up to make all of that happen."

The "Fertility Paradox" That Sets Asian Americans Up for Struggles

There's actually a term for what many Asian Americans experience: the "fertility paradox."

"The term 'fertility paradox' refers to how Asian American parents emphasize the importance of academic and professional performance and de-emphasize dating and building relationships and friendships (Inhorn, 2020). Because of this, Asian Americans during their 20s and 30s tend to focus on meeting the academic and professional expectations of their parents at the expense of having the time, space, and emotional availability to date and find a partner. It's not uncommon for Asian Americans to find themselves doing really well in their career because that's what they've been told should be their focus…and then in their late 30s, their parents are hounding them about giving them grandchildren."

What Surprised a Therapist About Asian American Fertility Struggles

Gee-Wong has noticed some patterns that don't get talked about enough in Asian American communities:

"Sometimes I've seen that Asian Americans attribute their infertility to a spiritual problem or a lack of faith, and family members have told them to 'trust God' or to 'pray more.' But when it comes to infertility, there could be a medical reason behind it, and diagnostic testing can usually identify something or rule things out. And sure, you can pray more, but sometimes that blocked fallopian tube just needs to be diagnosed and taken care of."

She also sees how the cultural emphasis on performance affects emotional well-being: "Because the culture can be so performance and externally focused, there's not much room for having a hard time. So if it's not working for you to get or stay pregnant, you might feel embarrassed or ashamed. I've seen people suffer in silence and confusion for a long time (like years!) before they finally talk to someone for help. So I wish that infertility was more normalized and talked about in the Asian American community."

Practical Advice for Asian American Families Dealing with Fertility Issues

Gee-Wong's recommendations are straightforward but important:

"Reach out for help sooner rather than later. There might be something small (or large) that is keeping you from getting or staying pregnant. Either way, you'll get more information and treatment. That's taking control of what you have control over. You can ask your ob/gyn for a referral to a reproductive endocrinologist."

She also emphasizes self-compassion: "Try to be gentle and kind to yourself during this process. Pay attention to the kind of thoughts and narratives you have going through your mind and notice which ones are helpful and which are not. You can still be a good daughter/son/cousin/friend and NOT attend that baby shower or kid birthday party if it's going to be too hard on you. There are other ways to support and celebrate someone. When you're ready, you can start attending all of those kinds of parties again if you want."

Building Your Support Network

One of the biggest challenges for Asian Americans dealing with fertility issues is letting people help them.

"Let people care for you. If you just found out that your embryo transfer failed, and your friend says to let them know if you need anything, let them do something nice for you! They probably feel helpless about how to support you, so give them a job ('Could you drop off a burrito? Could you text me every morning for a week to say hi?') I had a friend going through a miscarriage, and she asked me to text her what I ate for every meal for the next week as a way to get her mind off of her grief for a minute or two each day. I was happy to do that, and I was grateful that she gave me a very practical and specific way to support her."

Support groups can be particularly valuable: "Infertility support groups can be a wonderful resource. RESOLVE offers both peer and professionally led support groups. Some meet online and some meet in person, and some are specifically for people of color. It can be scary to try out a group. I recommend that people give a group a chance and attend at least three group sessions before they decide if they want to continue."

Setting Boundaries with Family

This is often the hardest part for Asian Americans dealing with fertility issues.

"Something that you do have control over when you're going through infertility is who to let in about your process and experience. By opening up, you'll most likely find more people than you think who have also experienced some fertility issues and/or pregnancy loss. These folks might be good support people for you."

But protecting yourself is equally important: "On the other hand, going through treatments and all of the waiting that's involved is emotionally draining and it's important to take care of yourself. If you know that certain friends or family members will offer unhelpful advice instead of encouragement and support, you can decide to not let them know what's going on. Setting boundaries ('I'll let you know when I have news.' or not telling someone when your transfer is) is necessary."

Coping Strategies That Actually Work

Gee-Wong addresses a common issue in Asian American families: not knowing how to deal with emotions.

"When you're going through fertility challenges, there are a lot of ups and downs and a lot of feelings! What makes this tricky though, is that it's not uncommon in Asian American families that what you want, how you're feeling, or your inner experience isn't valued. Therefore, children learn that their feelings don't matter and how they're doing emotionally doesn't matter. To cope with this, they stuff their feelings or disconnect with their feelings. Feelings aren't seen as a normal part of being a human, and also as a source of information about what you need."

This creates additional challenges: "So not knowing how to deal with your feelings or how to be gentle with yourself and your feelings can make going through infertility even more challenging. Infertility takes an enormous emotional and physical toll, and there are so many feelings involved (including feelings of uncertainty and hopelessness). All of these feelings make sense because of what you're going through! Give yourself permission to have these feelings. No one goes through infertility feeling neutral about it all. And feelings come and go. But sitting with and identifying these feelings is not something that most of us grew up doing. We were not taught how to do this by our parents. So it can be helpful to sit with a therapist who can help you pay attention to these feelings and hold them. This is a skill that many of us need to learn as adults, and that will serve us regardless of how the family-building journey turns out."

Finding the Right Therapist

Does it matter if your therapist shares your background?

"Not necessarily. The most important thing is to find a competent therapist that you feel safe and comfortable with. A competent therapist will have the skills, education, experience, and training to really understand you and will be aware of their own biases and assumptions regardless of their own background, and not let those get in the way of really seeing who you are and what you are going through."

However, she does recommend finding someone who understands fertility: "In terms of fertility though, if you're going through infertility, it can be helpful to find a therapist who specializes in infertility so you don't waste your time explaining to someone the difference between an IUI and IVF."

The Bottom Line for Asian American Fertility

Asian American women and couples face unique pressures when it comes to fertility - from cultural expectations about success to family dynamics that don't always support emotional expression. But understanding these patterns can help you navigate them more effectively.

The key takeaways: don't wait too long to seek help, be gentle with yourself during the process, set boundaries that protect your emotional well-being, and remember that having fertility challenges doesn't make you a failure in any way.

Your timeline doesn't have to match anyone else's expectations. Your feelings about this journey are valid. And getting help when you need it is taking control, not giving up.

For culturally competent fertility support and resources, visit Oshun Griot.