There are few conversations about sex that actually make me want to punch a wall — even three years later. But one conversation in particular has had that effect.

It was an office Christmas party, and a circle of women was engaged in animated chit chat about work, pop culture, and all the sorts of things you discuss at Christmas parties. We worked at a magazine that covered books, so I mentioned a book I read called The Impatient Woman's Guide to Getting Pregnant.

The second the title left my mouth, one woman, a 50-something with a blonde bob and photos of her two kids plastered around her office, snorted so loud she nearly dropped her drink.

"Oh PLEASE," she guffawed. "Is it just the words 'Have lots of sex' repeated for 200 pages??"

Modern women (and men) are blessed with an excellent body of knowledge on how to get pregnant. From middle school on, we learn precisely what activity winds up getting a girl knocked up. And so we spend the first 10, 20 — even 30 years of our post-puberty lives doing anything possible to not wind up pregnant.

And then, when/if we eventually choose to reverse gears and produce some babies, we think we know what's in store: sex, and tons of it. Nonstop orgies of pill- and condom-free sex. The flowing river of sex you always wished you could have. A wild circus of crazy sex positions and orgasms galore!

What no one mentions is that there's a perfectly good chance that you won't get pregnant on the first go-round. Or the second. Or the third. No matter the sex position. And that before you know it, the one activity that has been your go-to for pleasure in life has become a ceaseless, soul-crushing chore.

Yes, you read that right: Sex to conceive can be a miserable, pleasure-less act that makes you question why anyone does the deed at all (no matter how hot the foreplay or adventurous the sex position).

The fact is, getting pregnant can be very easy. Or it can be impossible. Some women slip and fall on a penis, and look! They're ready to give birth nine months later. Others spend years, thousands of dollars, and a good portion of their sanity on pills, injections, painful and uncomfortable procedures and more pills, only to wind up with absolutely zero results.

Modern medicine knows very little about the differences between these two types of women. Much of the time, doctors and science can't tell you which type you are. Your ability to get knocked up when you want to all depends on a million things going right at any one time (to the point that it's almost remarkable that anyone ever gets pregnant at all). And the kicker is, you won't have any idea which side of the spectrum you fall on until you actually leap in and start "trying." (See? Even the word we use for sex when it's supposed to result in pregnancy — "trying" — is unsexy. Trying.)

Personally, I've ventured pretty far into "meds, injections, and more meds" territory. After 13 years of dutifully taking my pill every day, I went off birth control full of optimism and enthusiasm. Bought new lingerie, started taking prenatal vitamins and read every book and website on conceiving that I could get my hands on. The key, all this literature said, is the timing. Getting pregnant is all about having sex when you ovulate. Which sounds obvious. Except when you actually try to do it.

The good news is that an entire industry of tools has been developed to figure out precisely when your ovaries release an egg. You can buy sticks to pee on and thermometers to stick in your mouth (or other places) and charts to fill in. And then you have to find that one 48-hour window, and have as much sex as possible during it.

Still sounds like a breeze, right? Sure, if you're two lab rats spending your days sitting in a glass-walled container. But if you happen to be two adults with jobs and social lives and Google calendars that fill up weeks in advance, good luck. The chances that you're both in town, not working late, and don't have some event on any given month seem to get slimmer every time.

Then there's the issue of getting in the mood. There is nothing as unsexy as sex that must occur at a certain time. The absolute best of activities can easily become work once it's, well, work. The context shifts entirely.

For me, sex quickly became nothing but stress. My head was a nonstop commentary session. "We have to do this now, and it has to be tonight since I have an 8:30 meeting tomorrow, and if it doesn't happen in the next nine hours, that means a full month down the drain." Plus, my husband isn't the "ready in a flash" type (and let's face it, despite the stereotype that men always want sex, nothing kills a boner like hearing, "Have sex with me now; I'm ovulating!").

Every month, it got more harrowing. My husband would look more and more pained whenever the happy face appeared on my ovulation predictor sticks, indicating that the window had arrived. Seeing this reaction, I started going to greater and greater lengths to seduce him. 'Ovulation time' meant his favorite dinners, bottles of wine, even Scrabble games where I deliberately let him win (well, ok, he beat me — but barely).

It's not like I was fooling him. "So I assume this means I need to get cracking?" he'd joke on those nights, after I pulled out the second bottle of wine. And then we'd have sex not because either of us really wanted to, but because we had to. Which was about as un-erotic as it sounds.

Sometimes we'd manage to snap out of the head games; One nice aspect of nature is that your libido revs up when you're ovulating, as does your attractiveness to men. That sex was great. It reminded us that we love each other, and we got married because we can be really connected and also produce multiple orgasms. But then the scheduling anxieties and time-tables and biological clock fears would creep back in, and all the passion would be flushed away.

Despite our best efforts, the year yielded a total of zero pregnancies. So I started down the infertility rabbit hole. Doctor visits, tests, more tests, pills, vitamins, supplements, shots, and a brutal schedule of 8 am blood drawings. Which only made time for sex even harder.

It's easy to dismiss this statement. "She’s just doing it wrong," you might say. "That won’t happen to me." Unfortunately if you're stuck in the fertility cycle, which has no clear end date and no guaranteed success rate, it's close to impossible not to drag your sex life onto the roller coaster of fears, stresses, and anxieties that come to dominate your life on a 28-day schedule.

Sex becomes a means to an end rather than an end itself. And the only way out of the hole is to pretend that the above sentence isn't true, and fool yourself (and your spouse) into believing that there's nothing at stake here, it's just another fun romp under the sheets. At least for an hour or so.

After a year and a half of this brutality, I finally have a diagnosis: I have a genetic blood clotting issue. It isn't serious, but in order to have a successful pregnancy, I'm going to have to give myself a shot every day for all nine months. Just the thing you want to think about when you're trying to get in the mood.

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At least I know I'm not alone. My realities in trying to conceive opened my eyes up to the realities of other women and couples. And while each couple has its own reason for having trouble in the reproduction department, our diagnosis is the same: Anxiety produced by uncertainty and a lack of control. One of the only known cures? Talking about it, and making sure we all know we're not alone.

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