This work reflects on the suffering and difficulties that men and women often experience during the process of procreation, beginning with the decision to suspend the use of contraception. The shared project that a child represents involves difficulties that are also a consequence of the culture in which we live: subject to early tests, ultrasound scans and so on, a planned pregnancy is dominated, throughout its development, by the secondary process of monitoring. A delay in conception, at times deriving from intolerance towards a body that does not immediately fulfil one’s own desires, sets in motion the diagnostic inquiry. During this time, while the long-awaited moment of conception is further delayed, the desire for a son/daughter changes in quality and intensity. In a substantial number of cases, infertility remains unexplained, a situation in turn characterized by the fear that not knowing implies. Although the excessively simplistic and limited notion of psychogenic infertility has faded, a residue of unexpressed horror, difficult to frame even in analysis, persists in the couple. The end of the diagnostic inquiry means that assisted conception must be eventually faced. Fortunately, nowadays in psychoanalytic culture the fundamentalist tendencies that, in the past, led to forecasts of catastrophe, have subsided. Yet this remains a highly problematic area with many questions and few answers.