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As a little girl, I never dreamed of motherhood. When I got married at 36, I assumed pregnancy would come easily. A year later it did, although at 18 weeks I experienced a devastating miscarriage. And a second early miscarriage not long after.

About 1 in 4 women experience baby loss; 1 in 8, infertility. As my 40th birthday loomed, I turned to in vitro fertilization, like many women my age with similar loss experiences. According to a 2018 study, 33 percent of Americans have used IVF or another form of assisted reproductive technology (ART) to get pregnant, or know of someone who has. That number is expected to grow.

But beyond the sweet images of healthy newborns used to illustrate IVF services, there’s a darker and less happy side to IVF that some people may not realize. Most significantly, it’s not that easy to have a baby with ART. The truth, I learned, is far more complicated — and painful.

I’d never heard of any fertility acronyms often bandied about during this process — such as TWW (a...