When you want a baby and it doesn’t happen, your relationship takes the strain. Susan Quilliam on coping with the emotional stress of trying to get pregnant

I was a longed-for child, born after twelve years of trying. And I used to think I was unusual. But, actually, infertility – whether temporary or permanent – doesn't affect just one couple in a million. A staggering one in six couples in Britain has problems conceiving.

Bad news

Couples start off hopeful, make love to make babies – until it gradually dawns, after a few months, that nothing's happening.

Then begins a flurry of desperate measures. Lovemaking needs to be timed for the best chance of conceiving – my mum used to ring my dad whenever the thermometer showed she was ovulating, and get him to rush home from work so they could do the necessary.

But, pretty soon, anticipation turns to concern, turns to downright worry – and at that point, one in seven couples seeks medical advice, and learns the worst – that there is a problem. Such news has a deep impact on both partners, and on their relationship.

If you learn that you have problems conceiving:

• Go easy on yourselves. You didn't choose to have this problem – it is absolutely not your fault. And it doesn't mean you are not a true man, or a real woman. So avoid guilt or blame – and if your partner gets guilty or angry, challenge it.
• Expect to feel emotional, and you should support each other to let that emotion out. Try not to put up barriers with each other – confide even your deepest fears.
• Offer lots of reassurance – both of you may fear that the other will leave because of these problems. Keep reaffirming your love – in words and cuddles.
• Stand together against the world. Others may make insensitive comments: ‘Are you firing blanks?’... ‘When are we going to hear the patter of little feet?’ – either ignore them, or explain, depending on what you’ve decided will work for you.

Taking action

When a couple opts for treatment, they face a whole new set of problems.

• They may start arguing about which treatment to go for.
• They may worry about the financial pressure, if NHS funding isn't an option.
• The treatment itself may be painful, and the waiting time for treatment an incredible stress.

Couples say that waiting to see if the treatment has taken is often the worst – a woman is worried every time she goes to the loo, in case she's started her period. The discovery that the treatment has failed can happen any time – so you may have to deal with the indescribable disappointment in the supermarket or on a crowded tube train.

If you are trying to cope with treatment:

Plan for the long haul. There will be a lot of ups and downs, elation and despair – the infertility process is a real emotional roller coaster.

• If you can, relax, go out, see friends, take a holiday.
• Getting a life outside the treatment will help, take account of the physical impact of treatment – so, for example, expect major mood swings, if you're receiving hormone injections.
• You will be offered counselling – take it. You may feel as if you want to cope alone, but the more outside support you get, the more resilient you'll be, mentally and physically – and so more likely to conceive.

Fertility treatment seems stunningly successful – over 50,000 babies have been born through IVF alone, since the birth of Louise Brown, the first test tube baby. But for many couples, the outcome's not good. There is no baby, no chance of a baby – and they have to call a halt to treatment. If you reach the end of the treatment road, you will feel bereaved. Hope has kept you going, and now it's gone. Expect to grieve all over again – and seriously.

One fifth of all couples experiencing infertility have even felt suicidal at some point. Once again, don't hold back from getting counselling and support. You'll need to refocus your lives and readjust your relationship. When you feel ready, put much effort into planning for the future. Remember that many childless couples stay together, grow closer, love each other dearly. There is life as a childless couple, and it can be a good life.After all, having children was not the only reason you married each other.

If you're coping with the stress of not being able to conceive, then the following organisations may help:

Infertility Counselling Association – Info line 01342 843 880 and website: bica

ISSUE – National Infertility Assoc. 01922 722 888 and website: ISSUE

CHILD – National Infertility Support Network 01424 732 361 and website CHILD

You may also want to read:

*Patients' Guide to Infertility & IVF - produced by The Human Fertilisation and Embryology Authority
*Infertility, A Sympathetic Approach by Professor Lord Robert Winston, £8.99.
*The Infertility Companion by Anna Furse, £9.99.