For those who have dreamt all their lives of having children, finding themselves infertile is a devastating blow. Couples may fall into the blame game.
They may see each other as defective. Or blame may be turned inward with an overwhelming sense of shame and worthlessness.
Family, friends and co-workers who don't know the situation can inadvertently bring added pain. "When are you starting a family?" or "When are you going to make me a grandmother?"
Others who do know the situation may cast blame on the husband in an attempt to shore up the wife. They may criticize the wife while trying to reassure a man about his masculinity. People can make misinformed assumptions about what's wrong.
And the compassion and pity can be a bitter pill to swallow.
Being around couples with children can be tortuous to those who can never have their own. They're all too aware of just how many pregnant women, couples with newborns, parents with toddlers and pre-teens are out there. People with children litter the landscape.
The infertile couple may have no taste or stomach for these happy campers. They may just want to avoid it all. Avoid their friends. Avoid their families.
Life can become narrow and colorless when children -- all children, and their parents -- are cut out of the scene.
Sexual problems can arise. Some spouses might feel, if we can't conceive, what's the point? If there's something wrong with me, how can I be desirable?
Libido and fertility can be inextricably intertwined, and when one goes, sometimes so does the other.
Having intercourse by the dictates of ovulation, movements during and after intercourse being regulated so that chances of conception are optimized, and always the question before, during and after the act of love of "will it work this time?" may lead to the joy of sex just drying up.
They're not completely powerless, though they may feel that way. When they're ready, there are options to consider. Adoption may be a possibility. Infertility treatments offer more hope than ever before.
Still, not every couple can adopt. And not everyone can afford infertility treatments.