Infertility treatments can bring hope to couples who have trouble conceiving, but they can also bring challenges that doctors don’t disclose.

In her candid new memoir, Of This Much I’m Sure  author Nadine Kenney Johnstone bravely reveals the challenges that infertility treatments can bring.

Here are 6 things Nadine believes everyone should know before starting treatments:

The quality of care and clinics varies widely

Do your research thoroughly and get second and third opinions before choosing a provider.

Treatment is as time-consuming as a part-time job

Between blood draws, ultrasounds, injections, appointments, phone calls, and follow-ups, the process will take over a big chunk of your schedule. Be prepared to manage conflicts at work and at home.

Talking about treatments is hard, but not talking can be harder

It can be difficult to tell family, friends, and colleagues about infertility treatments for fear that they’ll pry or give unsolicited advice. But the alternative–not telling anyone–can be incredibly isolating. Choose a select few to share with, and let them know in advance how best to support you when you do share.

There’s no way to control the process

No matter what you do – from drinking pomegranate juice to splurging on acupuncture – in the end, you are not in control of the process or the outcome. This will be frustrating.  Breathe.

Treatments may take a toll on your marriage

Few things put more stress on a relationship than infertility and treatments. Equal involvement is key. Ask your partner to be with you during injections or discussion with the nurses. Seek counseling together throughout the process.

There are no guarantees

Most doctors tell patients to be prepared for at least 3 cycles to better their odds, but this will not guarantee pregnancy. Think of the process as a marathon that relies on your endurance.

Treatments have helped so many couples conceive, but, Nadine says, the experience will go a lot smoother if you’re prepared.

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