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Every time I tell someone I’m pregnant, the first thought that grips my heart in terror is, “What if I have to tell them that it didn’t work?”

I’m pregnant. We’re pregnant! (Initially opposed to the royal “we” of pregnancy, my husband, Solomon, feels that after our long journey, he’s earned the right to partake in the annoying language of “we” even though he’s not actually with child.)

I’d always imagined this would be a time of unbridled joy, but nothing is that easy with I.V.F.

After three years, 10 doctors, nine rounds of fertility treatments, genetic testing in Israel finding no normal embryos, two egg donors and four miscarriages — this last figure being the most significant, I suspect — this pregnancy has been riddled with anxiety.

I think I have I.V.F. PTSD.

The bad feelings don’t go away just because the event is over. You can’t all of a sudden turn the switch on for happiness and well-being because you were in such a dark and scary place for so long. Even though you’d thought you were coping quite well during the trauma, when it’s over, all the pent-up emotions finally flood over you.

And even though you’re safe, you are constantly reminded of the past, replaying it over and over in your mind.

So many nights, I wake up clutching my stomach, sobbing to Solomon that I’m no longer pregnant because I have cramps, a mood swing, because I ate something bad. He holds me, tells me it’s going to be O.K.

But I’m still mentally preparing myself for the worst, running through the scenario at the doctor: the silence of the ultrasound technician when something is wrong, the stillness of the fetus, the trauma of everything suddenly being over. The knowledge that I’ll have to go through it all again. And maybe again.

I’m so sick with worry by the time we get to our weekly ultrasound that I can’t even look at the screen. I keep my eyes on my husband’s face until I see him smile, and only then can I venture a glance to check that the baby is there.

But it’s there. The baby is there! Even after a flu, a sinus infection and food poisoning, the baby is alive.

I hardly believe it. Yes, when I look at the grainy black-and-white screen at 10, 11, 12 weeks, I can see there’s a baby growing inside of me. But I know it for only about five minutes after we leave the doctor’s office. It reminds me of those interminable years of dating, when I was still swooning over a great guy, but a day later, I started to doubt myself. Did I really like him? Did he really like me? That’s how it goes after I leave the doctor — but with much greater stakes. By the next day, I’m no longer sure what I saw was real. I’m thrown into the reality I’ve known for far too long: the past.

“Let’s not think about the past, only the future,” said my doctor, my newest miracle worker, a reproductive immunologist who treats women with recurrent pregnancy loss and repeat I.V.F. implantation failure. “We have to get here to get there,” he keeps reminding me, but not in a chastising way. “But I know you won’t be happy until you have the baby in your arms.”

Happy! I want to be happy. I want to let go of all the hurt, disappointment, anguish, waiting, despair — and let’s face it, depression — of the last three years of trying to conceive. Because this time I’m really pregnant.

While medical experts disagree on when the second trimester begins — Week 12, Week 14.5? — either way you slice it, I’m there. Well into my second trimester. The diagnostic tests have been done, our parents have been told, our friends are slowly being let into the loop and expressing all the elation I wish I could allow myself to feel. Even my doctor thinks I’m in the safe zone, releasing me to a regular obstetrician. (I wanted to throw myself at his feet, clutch his ankles and yell, “Please don’t leave me!” but it would probably be undignified.)

Yes, there are a lot of things that can go wrong, even now. Sadly, that’s one of the things this fertility journey has taught me: to prepare for the worst. Along with years of my life, money, and relationships, I’ve been robbed of my optimism, my belief that everything always works out for the best. A lot can go wrong.

But now, as I feel the fluttering in my stomach, maybe I can start to believe again. That this time will be different from all the others. I have to stop replaying past traumas in my head. I need to rewire my brain with positive images, wonderful pictures of our baby moving — waving its hand, opening its mouth, lying with one hand behind its back, just like its mother — and think of the future.

We’re expecting! And I’m going to try to let myself be happy about it. Because I have waited for a very long time.

Want to know more? Amy Klein will be available for a live chat in the comments next Tuesday evening, March 24, from 9 p.m. to 10 p.m. Eastern time.