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Few things can make a woman feel more vulnerable than medical stirrups. Add the fear of infertility when trying to conceive, and it can feel like the loneliest place in the world.

Infertility is typically defined as the inability to conceive after a year of intercourse without birth control, or the inability to carry a pregnancy to live birth. The statistics vary by country, age and other factors. But the crux is that there is no need to suffer alone.

“Don’t take it personally,” says Christine Jamplis, an American dealing with fertility issues in Japan. “It’s not a race.” That’s good advice, seeing as navigating the processes and available options can sometimes make you feel like you’re stuck in gridlock.

It helps to know what can be done. So if you’ve “tried” for a while with no luck, and if temperature-taking and ovulation kits aren’t producing a big fat positive pregnancy stick, these are the basic steps.

First, a semen analysis for your partner and an HSG (hysterosalpingogram) for you, to check that travel of a fertilized egg would be unimpeded. Also, a blood draw at a certain point in your cycle will show if you’re ovulating and sending eggs down the fertilization highway. If not, your doctor can prescribe Clomifene (or similar) for ovulation stimulation.

If that doesn’t work, the next steps are shots of hMG (human menopausal gonadotropin) and other pregnancy-supporting hormones. If necessary, forms of IVF (in vitro fertilization) are also an option. While it can be daunting, just remember that you always have options and hope.

“If you suspect something is wrong, go get help,” says Windsor Redick, a military service member who’s dealt with infertility and now has a healthy kiddo. “I kind of kept the infertility struggle bottled up socially while we were going through it.” When she found herself getting emotional as yet another friend announced a pregnancy on Facebook—or even when women walked by with multiple toddlers in tow—having an email friend to whom she could vent made all the difference. “She was there for me and would just listen. It was exactly what I needed,” she says.

The brightest side of Japanese fertility treatment is its relative affordability. And while not available to everyone, many expats and military service members can access a medical translator. They’re more than interpreters—they’re kind, hardworking professionals who go the extra mile, advising you on everything from the kinds of sushi that are safe to eat during pregnancy to giving directions to maternity shops.

For her part, Jamplis commutes to Yokohama’s Fukuda Women’s Clinic. While the trains are rush-hour mad at any hour, she says the environment of the small but well-known establishment is like being in someone’s home. There’s only the doctor and nurse—and if patients aren’t in the first wave when the doors open, they won’t get a seat in the assembly line of a waiting room.

The key is to never abandon parenthood, and to try to not focus on money—or that lonely sense of exposure when your legs are spread before virtual strangers, a curtain separating you from the medical staff, your translator a timid parrot at your side. But there is a definite upside: by the time you’re done, you learn to feel you definitely deserve to be a parent.

English-Speaking OB/GYN Hospitals & Clinics

• Seibo Hospital, Shinjuku
• Sanno Hospital, Akasaka
• Fukuda Women’s Clinic, Yokohama

Sample Price List

• Human menopausal gonadotropin (hMG) treatment: ¥3,500 (minimum) per shot, approx. one shot per day for 1-2 weeks
• In vitro fertilization (IVF): ¥300,000 (first try); ¥250,000 each time thereafter

*Excluding consultation fee

Source: www.fukuda-wclinic.com/costs.html