The Infertility Journey

What Happens When Trying Takes Time

Fertility is a constant background hum—even when no one is “talking” about it. We’re reminded it has a clock: tracked, warned about and judged—from age milestones and algorithm feeds to the cultural drumbeat of declining birth rates. But when trying to conceive becomes hard, the experience can be deeply isolating.

The quiet reality is that infertility reshapes families long before a child arrives—through testing, treatments and reckonings that rarely make their way into conversation, much less headlines. In a culture that still treats pregnancy as something that “just happens,” the disconnect can be jarring. We are bombarded with messaging about how to prevent pregnancy, not how difficult it can be to achieve or what it asks of the people trying—like an open tab you can’t close.

According to Danielle Melfi, CEO of Resolve, The National Infertility Association, “1 in 6 people in the U.S. struggles with infertility… and everyone knows someone who has been impacted by infertility and family-building challenges.” The toll isn’t confined to reproduction alone. It can be physically taxing, emotionally destabilizing and financially draining. Over time, the internal question shifts from “Why can’t I get pregnant?” to “What does trying actually ask of me?” And the answer isn’t linear. Effort doesn’t equal outcome—a hard truth in a world that often promises results if you simply try hard enough.

Providers emphasize that fertility challenges are rarely singular. “In reality, it’s a shared diagnosis—not an individual one,” says Atlantic Fertility co-founder Dr. Susannah Copland. By testing both partners early, families can avoid months of waiting, extra expenses and emotional whiplash, she says. 

And waiting doesn’t make fertility problems easier to solve, she adds. By then, decisions can feel urgent and overwhelming. “If someone is trying to conceive and is not yet there after a year under 35, or six months over 35—or if they already know something might be up (endometriosis, PCOS, surgery for an undescended testicle), that’s when to start [with evaluation],” says Copland, noting this gives people more options, not fewer.  

While there are many paths forward—intrauterine insemination (IUI), in vitro fertilization (IVF), donor eggs or sperm, embryo programs (a fertilized egg in early development), or choosing to stop altogether if it doesn’t stick—each option carries its own medical, emotional and financial realities.

Infertility & the Age Myth: What the “Fertility Clock” Gets Wrong

When people talk about fertility and age, they often reduce it to a single stat. But fertility isn’t governed by one clock—and it doesn’t decline the same way for every part of the reproductive system, notes Copland.

Egg quality does change with age—and that matters. As people get older, eggs are more likely to have chromosomal differences, which can affect fertilization, embryo development and miscarriage risk. That decline is real, but it’s gradual, not sudden—and it varies widely from person to person.

One common misconception is that aging eggs automatically means a woman can’t carry a pregnancy, says Stephanie Bartlett, a women’s health nurse practitioner and program director at Shared Beginnings, a unique model founded on the concept of sharing, whether fresh or frozen egg donors; fully screened high-quality, ready-made embryos; or personalized embryo creation. In reality, the uterus doesn’t age on the same timeline.

“People often assume that if egg quality or quantity declines, that means you can’t carry a pregnancy—and that’s just not true,” explains Bartlett, who also serves as director of third party services at Atlantic Fertility. “Women in their late 40s may not be able to use their own eggs, but we can create embryos and implant them beautifully into their uterus,  and they have a happy, healthy pregnancy and delivery.” As such, adds Copland, many women are starting to egg bank so they have the option to be their own first egg donor, though “working with another egg donor works very well because the uterus is eternally young.” 

That distinction helps explain why some treatment paths—like using donor eggs or donor embryos—can result in higher success rates, even for patients in their late 30s or 40s. “When embryos are already created and tested, you’re removing some of the biggest biological variables,” says Bartlett.

And, contrary to common thinking, fertility isn’t only about the female. Sperm matters too—in ways that are often overlooked. While it’s produced continuously, age and overall health can still affect quality and genetic stability, shaping outcomes just as much as egg age, says Copland.

Ultimately, she stresses, age is best understood as one variable among many. Underlying diagnoses like endometriosis or PCOS, prior surgeries (including an undescended testicle), uterine health and overall medical history all play critical roles in determining which options make the most sense, and when.

In practice, that nuance can be clarifying. Fertility decisions aren’t about racing a single deadline—they’re about understanding which factors are in play and choosing the path that fits biology and real life.

Infertility Success Rates Explained: What IVF & IUI Numbers Really Mean

When it comes to fertility treatments, success rates are often the first thing people Google—and the hardest to interpret. A percentage can feel like a promise—or a verdict—when it’s really neither.

Clinics calculate success rates in different ways, says Copland. Some report pregnancy rates per cycle; others track live births. Some numbers reflect outcomes for younger patients or those using genetically tested embryos, while others represent a much broader—and more variable—group of patients. As a result, comparing clinics or outcomes can be misleading.

Age plays a role, but not in the cliff-edge way many people fear. “The idea that fertility falls off a cliff at 35 isn’t accurate,” emphasizes Copland. “It’s a gradual decline—for eggs and for sperm.” Outcomes depend just as much on egg quality, sperm factors, uterine health and underlying diagnoses as they do on birthdays. The type of treatment matters too: Success rates for IUI, IVF, and donor or embryo programs are calculated differently, and each comes with its own set of assumptions baked into the numbers.

To put that variability in context, Copland points to IVF data. Among patients under 35 using embryos that haven’t been genetically tested, pregnancy rates typically hover around 50% per cycle. With genetically tested embryos, pregnancy rates per transfer rise into the 70% range. Even for patients over 42, genetically tested embryos can still offer a ~50% chance of birth. Genetic testing doesn’t erase age-related decline, Copland notes—but it helps avoid transferring embryos that are unlikely to succeed, effectively improving the odds. 

“It’s frustrating not to be able to give an average because it is based on age and egg number and diagnosis,” she says. Because averages can be misleading, they use national data tools to personalize expectations. Copland says her team plugs personalized facets into a calculator from the Society for Assisted Reproductive Technology, grabbing nationwide IVF data to estimate a patient’s likelihood of birth across one, two or three embryo transfers.

Advocacy groups like Resolve emphasize that statistics alone can’t capture the emotional, financial and logistical realities people face as they try to build a family. It’s also why hearing about someone else’s “quick win” or devastating stop can distort expectations and decisions. 

For fertility treatments, numbers offer context, not guarantees—and they don’t paint the full picture. Understanding what success rates can—and can’t—tell you is often the first step toward setting realistic expectations, protecting mental health and making informed decisions about how long, and how far, to keep going.

The Cost of Infertility Treatment: IVF, IUI & What Insurance Covers

One of the biggest misconceptions about fertility treatment is that there’s a single price tag—or that insurance will reliably cover it. In reality, costs vary widely with diagnosis, age, treatment path and geography, and many expenses fall outside what people expect when they first begin.

As a baseline, IUI is often the least expensive medical option, typically ranging from a few hundred dollars to a few thousand per cycle, depending on medication, monitoring and whether donor sperm is involved. IVF is far more complex—and costly. A single IVF cycle commonly runs in the $20K–$25K range before insurance,
says Copland. 

“Most conventional IVF cycles—meaning egg retrieval and embryo transfer—are going to land in that range because they’re resource intensive, with highly specialized labs, medications and skilled embryologists,” she says—“and because we don’t have enough people covered by insurance in this country, which would bring things down.”

Those base numbers seldom tell the full story. Medications alone can add several thousand per cycle. Genetic testing of embryos is often billed separately, as are anesthesia, lab fees and long-term storage of frozen embryos. And because success isn’t guaranteed on first attempt, many face the possibility of paying for multiple cycles.

Alternative models can change that math, though not eliminate it. Programs like Raleigh-based Shared Beginnings lower certain medical costs by pairing advanced embryo tech with a shared-donor model.

“What has been most revolutionary in infertility care is culturing embryos out to the blastocyst stage and being able to do genetic testing on embryos,” says Copland, and those advances have helped boost pregnancy rates per transfer. Shared Beginnings builds on that progress by pairing high-impact technology with a shared model intended to make treatment more affordable and accessible.

“The fertile soil that grew Shared Beginnings was that the Triangle has a lot of wonderful egg donors and recipients who were in the early days of figuring out the sharing,” she says, “enough that we could find a way to decrease cost and increase access.” The program was built around a shared-donor approach, in which a single egg donor cycle can serve more than one family. If a patient or couple needs only a portion of the eggs, the remaining eggs can be allocated to another family or preserved for future use—reducing waste, lowering costs and expanding access.

Bartlett adds that treatment paths can also differ depending on whether families use frozen or fresh eggs—and because Shared Beginnings offers both for families to tailor to their needs, the fresh-donor ecosystem is especially unique.

Clinically, the choice can affect outcomes. While they are both great options, says Bartlett, fresh eggs tend to fertilize better and yield more embryos—which can matter for families hoping for multiple children—while some frozen eggs may not survive thawing, but are lower cost and can provide a reserve. Male factor infertility can also affect how well frozen eggs fertilize. Both approaches can work well, she says, and the right choice depends on each family’s circumstances.

Insurance coverage, meanwhile, remains inconsistent. According to Resolve’s Melfi, “If you’re impacted by infertility, your ability to build a family depends on where you live, what insurance you have, and what out-of-pocket costs you can afford—that is unacceptable.” The financial reality becomes inseparable from the emotional one—another layer to weigh while deciding how, or whether, to keep going.

Infertility Treatment: When IUI, IVF or Donor Paths Change

Fertility treatment isn’t a straight line—and the path someone starts on isn’t always the one that ultimately leads to parenthood.

“Anybody who wants to have a conversation about their fertility,” says Copland… “does not mean you are immediately placed in treatment. … We see people who are just curious, who haven’t even tried yet, who just want to have a conversation as they’re framing their family.”

But when conception doesn’t happen naturally, would-be parents may move to medical options like IUI or IVF. When those routes don’t work—or aren’t the right fit—other paths come into play, shaped by a mix of biology, timing and personal circumstance. “It’s so critical to see every family vision, every fertility pathway for all of the aspects of egg, sperm, embryo, uterus,” says Copland… “and not just focus on any one area where you’ve identified a concern because you may be missing something important.”

One common point of confusion is the difference between donor eggs and donor embryos. With donor eggs, a patient uses eggs from another person, fertilized with sperm of their choosing, and carries the pregnancy themselves. Programs like Shared Beginnings take a different approach: Donor embryos are created and genetically tested before transfer, reducing uncertainty around egg quality and early development.

That distinction is often what draws patients to these programs. “For many people, this path offers clarity… and helps some patients feel more confident moving forward—especially after years of trying,” says Bartlett.

Other options, like INVOcell, provide a hybrid version of IVF that allows fertilization to occur inside the body rather than in a lab—often at a lower cost—while still using assisted reproductive technology and expanding access for those who may not be traditional IVF candidates.

What these options share is choice—and the understanding that family building doesn’t follow a single script. Shifting paths isn’t failure; it’s adaptation. In many cases, letting go of the “original plan” creates space for forward movement.

Infertility & Mental Health: The Emotional Toll of Trying to Conceive

Infertility isn’t just a medical experience—it’s an emotional one that can quietly seep into every corner of daily life. The waiting, the cycles, the tests, and the constant recalibration of hope and expectation can take a psychological toll.

Many people describe infertility as a form of ongoing grief—for the timeline they imagined, for the body they thought they could trust, for the ease with which others seem to move forward. Anxiety and depression are common, as are feelings of isolation—especially in a culture that still treats pregnancy as a private milestone rather than a shared struggle.

That emotional strain, providers say, can’t be separated from treatment itself. “We talk about mental health from the very beginning,” says Copland. “Support isn’t optional. It’s part of care.” 

For some patients, that means reinforcing basic wellness—prioritizing sleep, nourishing food, joyful movement and moments of connection even amid treatment. For others, she adds, it means working with their reproductive psychologist to process how heavy the burden can feel and develop techniques to manage it. 

Copland notes that while long-term happiness tends to level out regardless of how families ultimately form—through genetics, donor pathways or adoption—the experience of navigating infertility itself can feel intensely heavy in the moment. The goal, she says, “is making sure they have the resources that can help them keep wind in their sails and gas in their tanks, and keep moving forward.” 

That support extends beyond the clinic. For its part, Resolve runs roughly 200 free support groups nationwide across more than 36 specialized spaces—including groups for people over 40, LGBTQ+ individuals, Spanish speakers and Native Americans—serving ~2,000 people each month.

According to Melfi, 81% of people who attended six or more support group meetings reported feeling more in control as they navigated infertility—a meaningful shift in a process that can otherwise feel unpredictable.

Support doesn’t erase uncertainty or loss, but it can soften isolation. Whether through counseling, community groups or trusted care teams, having space to process the emotional weight of infertility can mean the difference between enduring the journey alone—and feeling supported while moving through it.

Infertility Language: Why the Words We Use Matter

For those navigating infertility, language isn’t just semantics—it can shape how the experience is carried.

“One of the biggest shifts I experienced was around the idea of being ‘childless’ versus ‘child-free,’” says Nicole Taylor, who has undergone multiple rounds of IVF. “If you tell yourself you’re childless, that can feel devastating. Reframing it as child-free—especially when it’s by circumstance, not choice—can be liberating.”

Terms like trying to conceive, infertility and subfertility are still evolving, as culture moves toward language that leaves room for uncertainty without assigning failure. The shift isn’t about minimizing grief, shares Taylor—it’s about creating space for dignity, agency and multiple possible outcomes.

The evolution is increasingly reflected in clinical care as well, where providers emphasize fertility journeys don’t always end the same way—and that words should honor that reality. Changing the language doesn’t change the outcome—but it can change how people survive the process.

Infertility Access and IVF Laws: What Patients Worry About

For many patients, a quiet anxiety runs alongside treatment: Will this still be available next year?

With shifting legislation around reproductive health, Copland says this is one of the most common—and fraught—questions they hear.

As fertility care continues to command national attention, some worry whether access to IVF, embryo preservation or donor options could change midjourney.

The concern is valid, but context matters. While laws vary widely by state, IVF, embryo creation, and family-building treatments remain legal and available in NC. What’s far less consistent is coverage. Because most fertility care is still excluded from standard plans, access often depends more on geography and employer benefits than on medicine.

That uncertainty is why transparency matters. Copland encourages patients to ask questions early, stay informed and discuss any concerns directly with their care team. “Uncertainty can be unsettling,” she says, “but right now, fertility care is continuing—and patients shouldn’t delay seeking care out of fear.” 

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In their own words: Nicole & Neil Taylor

I distinctly remember the “crying shower” where I made a deal with the powers that be. As I sobbed through the steam, I promised I would finally talk about the hell that is trying to conceive (TTC) if I could just get one healthy baby. 

At that point, I had been trying to get pregnant for more than three years. I had gone through six IUIs and three rounds of IVF egg retrievals. When the first IVF round didn’t work, I was crushed. How could it not work? We spent the money. We put all the pieces where they were supposed to go. And still, it didn’t work.

As my mental health really began to suffer, a coworker asked the dreaded question: ‘Are you going to have kids?’ I could feel tears welling as I tried to stay composed, answer politely, and keep my voice steady. ‘We’d like to,’ I said, ‘but it’s proving harder than we thought.’ 

I hadn’t shared our struggle with many, and I braced myself for what might come next. Would it be ‘Just relax—it’ll happen,’ or ‘Have you tried acupuncture?’ (I had.) Instead, she was kind. She told me about a friend struggling with infertility who had started attending a Resolve support group where people shared their experiences. It sounded awful. Absolutely not, I thought.

I didn’t want to talk about the pain. I just wanted it to end. But eventually I went, and it was a turning point for me. I found a community of people who were struggling the way I was. The meetings gave me perspective, and women who had been in the process far longer became quiet mentors, teaching me what questions to ask and how to advocate for my care. Most importantly, I didn’t feel so alone. I also began to imagine a possible future without children. I learned the language of being “child-free” instead of “childless,” and even allowed myself to consider the pros of that life.

The crying shower worked. Or rather, the advanced medical care and years of persistence did. Ten months later, our healthy baby girl was born. When she was about 18 months old, we tried to give her a sibling. Three more IVF egg retrievals—none successful. On the final round, my ovaries were so swollen they were touching, pain radiating with every step. I told my husband: ‘Don’t let me do this again. We are lucky. We have her. We need to stop.’

Over the course of treatment, 104 eggs were taken from my body. We spent tens of thousands of dollars, even with good insurance. I cried in showers, doctors’ offices and at home. And since then, some of the closest friends in my life have gone through their own TTC journeys. We understand what it costs—physically, emotionally, financially—to try to build a family, and how that understanding stays with you long after the trying ends.

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In their own words: Misti Robinson, Elaine Land + Adelyn

We started our journey in March 2015, meeting with Dr. Copland and deciding to try IUI, hoping for the best. When that first attempt wasn’t successful, we began talking about IVF—but then Misti got the news in late October that she would be having brain surgery. We paused everything. 

Over the next several years, every time we felt ready to start again, another roadblock would appear, whether financial, health-related or otherwise. Through it all, Dr. Copland assured us she and her team would be there when we were ready. 

Finally, in January 2023, we were in a place where we were ready to move forward with IVF. Elaine had her egg retrieval on March 17, 2023, yielding 12 eggs. Only four embryos made it to the blastocyst stage. 

We chose to have the embryos genetically tested. One female embryo was genetically normal, one inconclusive and two not compatible with life. 

While we mourned the two that were not compatible with life, we were excited and ready to move forward with the embryo we knew was genetically normal. We transferred the genetically normal embryo in June, but it ended in a miscarriage. Heartbroken, we decided to try once more with the inconclusive embryo. That pregnancy lasted longer—but ended in miscarriage. This time, we were devastated. 

We met with Dr. Copland later that year about our options. We could go back to the drawing board, with Elaine undergoing another egg retrieval and hoping for mature eggs and embryos that would have good genetic testing, or we could go with the Shared Beginnings program, where the embryos were already there and genetically tested. 

We asked one question, “What gives us the best chance at a family?” Dr. Copland told us it was to go through the Shared Beginnings program. So that is what we did. 

On April 22, 2024, we transferred our embryo, which would later grow into our double rainbow baby girl, Adelyn. In fact, the night of the transfer, Elaine had a dream that a little girl came up to her and said, ‘Hi mama, my name is Adelyn.’ From that point forward, we always knew her name would be Adelyn. 

When we got married, we both knew we wanted a family. We knew the journey to get here wasn’t exactly going to be easy, but we didn’t know it would be this hard. 

From the beginning, we had access to resources that helped carry us through—to navigate our two losses and the stress and anxiety of a healthy pregnancy after loss, and an adoption attorney to ensure we both have equal parental rights. We can’t even explain how much the comfort and encouragement from Dr. Copland and the team at Atlantic Fertility gave us during this time.

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In their own words: Jazzmin Jones + Alyanah

When I was a teenager, I always said I wanted to have a baby by 23. That didn’t happen. I waited, thinking there was no rush—until my mom sat me down one day and said, ‘You should go to a fertility clinic and get yourself checked. You’ve never had an accident.’

At first, I brushed it off. But in my late 20s/early 30s, I finally went. That’s when I learned I had eight to 10 polyps in my uterus. Ten months later, I had four more—plus a fibroid. I had surgery twice within a year to remove them. Doctors told me this was likely why I hadn’t been able to get pregnant.

At the time, I was in a relationship and trying. When that relationship ended, I put everything on pause. I didn’t feel urgency yet. But when my hormone levels were tested, I was told my numbers were very low for my age—and they dropped even further a couple of years later. By then, I was 38—and I had always said I wanted a baby before 40. I decided I didn’t want to wait any longer.

I also made another decision: I didn’t want to wait for the “right” partner. I had seen too many friends end up raising children alone after relationships fell apart. I didn’t want to build my future around someone else’s uncertainty.

I initially explored using sperm from someone I knew, but the logistics didn’t work out, and my doctor didn’t feel it was worth the cost or effort given my hormone levels. That’s when I began researching options—egg donors, sperm donors, embryo programs. I looked at multiple sperm banks and was struck by how few African American donors were available. That was another turning point.

Eventually, I found the Shared Beginnings embryo program. One profile stood out immediately: the woman was half Black and half German—just like me. She was light-skinned, with curly brown hair. It felt right. I originally thought about using only an egg donor, but the embryo option made more sense financially and medically, especially since the embryos were already genetically tested.

The cost was significant—$18,500 for the embryo alone—and I couldn’t qualify for the loan on my own. My mom stepped in and took it out for me. I didn’t intend to put that pressure on her, but she knew how much this meant. I had an incredible support system through the entire process.

At the transfer, I watched the embryo on a screen as it was placed inside me. My mom and my daughter’s godfather were in the room, and a friend joined us on video. When it was over, I walked out thinking, I have a baby in my belly. Two days later, I went on a cruise—not fully realizing I was already pregnant. Looking back, I think I knew it worked. I slept constantly. My body felt different.

The medication process was intense: daily estrogen, injections for weeks, needles everywhere. I joked that I had a soda bottle full of them. But eventually, she stuck. She stayed.

My daughter was due April 17, 2025, and she was born April 11—healthy and strong. I carried her to nearly 40 weeks. I worked as a flight attendant until walking through the airport became too painful. I watched myself give birth in a mirror and cut my own umbilical cord.

Before this, I worried about the fact that she isn’t genetically mine. But after carrying her, giving birth and holding her, that fear disappeared. She is my gift. And somehow, she looks like me. People told me that early on, and I assumed they were being kind—until I compared baby photos. We really do resemble each other. Even her eyes are brown, like mine.

If having a baby is something you truly want—and you understand the responsibility—I would tell any woman to go for it. Biology doesn’t define motherhood. Love does.