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Christmas is a time for children, and for women struggling to conceive it can often be the darkest time of the year.
One Kent woman has revealed she was left feeling lonely, sidelined and even lost over the festive period.
Ruth Jones from Coxheath near Maidstone was diagnosed with polycystic ovary syndrome in 2003, which can cause problems for women trying to get pregnant.
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Following that, the 38-year-old spent three years trying to start a family via methods including reflexology.
After they proved unsuccessful, she and her husband turned to their last hope: IVF.
At a time she was so desperate to start a family, Ruth was forced to engage in conversations centred around things like Santa’s grotto, nativity plays and festive activities.
Christmas became one of her darkest and most difficult periods of the year.
Video: A mum of twins talks about how IVF changed her life
She said: “I often spend Christmas with my husband’s family and there are young children and they are very much the focus.
"Christmas day itself is always very centred around what they want to do and seeing their faces as they open their presents.
“That is the right thing but I quite often felt not really included and kind of a little bit left out.
"As you’re getting older it’s not so much about going out and partying at Christmas anymore so I was just a bit lost, it was neither one thing nor the other.”
She added: “Seeing the joy and love between the other children and parents is a funny one to swallow when it's people that I love.
"I want them all to be happy but it also brings home that cold 'Bridget Jones' moment that this is all a life for other people and not for me, especially as each year is another one closer to 40.
“I've become more and more withdrawn at Christmas and I have felt that I may have been in the way with my subdued mood, desperately trying to find some Christmas cheer.”
In Kent, women are offered two fresh attempts at IVF, as long as they fulfil specific criteria for NHS treatment. If they get to freeze embryos, they are also entitled to two frozen treatment cycles.
In Ruth’s case, she had to pay about £5,000 as she and her husband didn’t meet the critieria, due to him having children from a previous relationship.
The figure is usually the cost for a standard course of treatment but increases with additional techniques, including the use of embryo glue which slightly enhances implantation.
The accountancy teacher’s first cycle of IVF in July 2014 proved successful as just a month after the embryo transfer, she received confirmation that she was pregnant.
Less than 18 months later, Ruth is preparing to mark her first Christmas with children, after giving birth to twins, Persephone and Ethan, in March.
She said: “This year is completely different. We’re going to be spending Christmas with my husband’s family. They’re very excited about them being able to rummage through their presents. It’s definitely a different feeling to what I’ve had previously.
“We’re very much looking forward to Christmas this year.
"Last year we didn’t even bother putting a tree up and I’d kind of built up almost a barrier against some of my friends who were having children by trying not to spend too much time around them, especially around Christmas.”
Ruth’s years of distress, particularly around Christmas, are appreciated by one Kent fertility clinic.
CARE Fertility in Tunbridge Wells carry out around 420 to 430 fresh IVF cycles a year, as well as frozen embryo transfers.
Michael Rimington, medical director at CARE, said: “I think it can be very difficult for couples to have treatment at Christmas time when they’re seeing families all around them and certainly if treatment doesn’t work, it can be very depressing for them.
“I have to take heart that over a course of treatment, most couples are getting a good result in the end.”
Michael added: “We’re looking at pregnancy rates for the women under 35 in the area of 50 per cent or so, so that’s very encouraging.
"The way we can put it to the couples now is that over a course of treatment for the younger women, it’s probably going to work.
“I think if you’re trying to have a family, it’s reasonable to attempt treatment so even if it doesn’t work, you know you’ve done your best to have a child so that perhaps gives a degree of closure that you’ve at least tried."
However, for many women who try it, it is stepping into the unknown.
The name is often bounced around in the media but what do women have to actually put themselves through?
Ruth said: “The worst things really were having to inject yourself and panicking about whether you’d got the right mixture. All the injections were quite stressful.
“The drugs made me super hormonal, I was fairly emotional already with the whole ordeal, convinced it wasn’t going to work, that we were just spending all this money and didn’t know for certain if it was going to be ok.”
She added: “When we had the egg collection, I slept through most of the procedure but when I woke up towards the end, it was very painful.
"After we had the egg collection, I was very emotional and very depressed actually for the next couple of days. I was very sick as well."
Even since getting pregnant and giving birth, Ruth has felt on the receiving end of people’s ignorance and poor understanding of the subject.
She said: “I think it is something that is still fairly taboo.
"I’m not going to apologise at all for how we conceived but when people say are your twins natural or did you have IVF or are there twins in the family, it’s that kind of hidden question almost.
"I’m quite proud now to say yes, we did and it worked first time.”
For Ruth, she believes her journey was all worth it and that has hit home, this Christmas.
The mum-of-two said: “This Christmas is a completely different feeling. We are now a complete family.
"My husband and I are so happy and feel so lucky and we’re just looking forward to spending Christmas together and feeling as if we’re all included together now as a family unit and not on the outside anymore."