Nobody expects to be in for the long haul when they start trying for a baby. It is supposed to be a time of great hope and anticipation, when you start planning your new lives together. It is true that having a baby changes your life, but not having one changes it so much more. Sadly, this is something that more than one in six couples will find out.
Before I became that statistic, I never thought too much about what it meant. Although infertility was a fear, it was not something that bore heavily on me - at least, only to the extent that I didn't want to put off having children for too long, just in case. I didn't know anyone who was infertile so I could only guess at how hard it might be.
I didn't have a clue. My guess only extended to the long-term pain a couple might feel about not having a child in their lives. Thanks to television, many people assume there is a once-off diagnosis a couple has to deal with, and that they are then free to return to their lives and reshape their future without their much-wanted child. If only it was that easy.
It is very difficult to explain the cumulative effect of month after month, and year after year, of hope and disappointment. After a while, everything hurts - other people's bumps and babies, anniversaries of failed cycles and lost babies, and every new birthday, Christmas and Mother's Day you face with empty arms.
There is a huge lack of understanding of infertility in the outside world. It is just not viewed as one of the very bad things in life. A common reaction is, "Why can't you be happy with what you've got? Focus on all the good things in your life". When you can't have a baby, nothing else matters. It's not possible to forget about it, channel your energy elsewhere, take up a hobby. The desire for a child goes beyond the desire for the joy that a child brings - it is a primal, uncontainable urge that overpowers all reason.
Infertility is a very difficult and painful struggle. The research of Dr Alice Domar, professor at Harvard Medical School, suggests that the stress endured by infertility patients is comparable to that experienced by people undergoing treatment for cancer and Aids.
Sometimes this stress can be compounded by people with the best of intentions. "Don't worry, it could be worse." "It's God's will." And the old chestnut: "Just relax and it will happen." If there is one piece of advice I can give to those who know someone suffering from infertility, it is that it is better to say nothing at all than to say the wrong thing. If you feel awkward, just say sorry, and give the person a hug if you think it is appropriate. And one more thing, if I may: stress does not, I repeat, does not cause infertility, but infertility sure does cause stress.
Unfortunately, it's not just emotional, physical and mental stress - there can also be a huge financial burden. At up to £6000 a go, and with less than a 25% success rate, IVF can become very costly. And for those who don't have a spare few grand, a diagnosis is often the end of the line.
I know what some of you are thinking: the world is overpopulated already, so many unwanted children out there, why don't you "just adopt"? Setting aside the huge amount of time and money needed to adopt, I always wonder why the burden of looking after the world's orphans falls on the shoulders of the infertile. What about those who've already experienced the miracle of pregnancy and birth - why don't they adopt instead of having, say, a second or third pregnancy?
Others may be concerned about the embryos that don't make it through the IVF process. Even with a "natural" conception, only 20-40pc of embryos make it to implantation. Life may or may not begin at fertilisation but viable life does not begin until the fertilised egg has implanted in the uterus. There is nothing that can be done to protect an unimplanted embryo - you can give it a right to life in law but unfortunately science cannot give any such guarantees.
With one in six couples seeking help to conceive, everybody knows somebody suffering from infertility. It's an issue that touches all of us either directly or indirectly. And yet it is a conversation many of us have never had.
October 28 to November 3 is National Infertility Awareness Week. Let's start the conversation.
Fiona McPhillips is the author of Trying To Conceive and a co-founder and director of the infertility charity, Pomegranate.