(CNN) From celebrating the everyday joys of being a new parent, to preparing to adopt another child, to contemplating future pregnancies, four couples who have struggled with infertility are moving forward.
One year ago, for Infertility Awareness Week, CNN spoke with these couples about their infertility experiences and the variety of ways they hoped to build their families.
Since then, they've continued on their journeys. Here are the steps they've taken in the past year.
Caitlin and Jeff Morton have been married for 5½ years and have endured a heartbreaking struggle with infertility for five years. In the first 4½ years of their marriage, she miscarried four times and made three intrauterine insemination attempts without success. An ectopic pregnancy resulted in an emergency surgery to remove a fallopian tube that was about to rupture.
Over the past year, Caitlin tried several IVF cycles. One ended in another miscarriage, and others failed, which encouraged her to get a second opinion. After researching infertility doctors, she saw Dr. William Schoolcraft, the founder of the Colorado Center for Reproductive Medicine, who handles extreme cases.
Schoolcraft said her other fallopian tube was damaged and full of scar tissue, and embryos weren't able to be implanted. He believes it could be from past ectopic pregnancies or undiagnosed endometriosis.
Removing her other fallopian tube removed any chance of conceiving naturally, but this also means that through IVF, Caitlin might be able to get pregnant in the future.
As she heals from the recent surgery, Caitlin and Jeff contemplate their next move. They're unsure about what to do next and fed up after so many experiences with short-lived hope and devastating loss.
"To know we will always have to do IVF to have children is frustrating and very expensive," Caitlin said. "One thing I know for sure is that we would make an amazing mom and dad and give a child the most amazing life! But right now we have to figure out the financial burden versus our other path of just being husband and wife and being OK with that as our family."
Their health insurance does not cover infertility treatments. It covered her tube removal and emergency surgery, but the Mortons, who live in Washington state, don't want to go bankrupt trying to have a child or make it hard to provide for a child.
"I don't know if we will have a success story for the end of our infertility journey," Caitlin said. "But I do know that we have to continue to dream big and live life to its fullest. With or without a child, we only get one shot at life, and I want to enjoy every day."
Starting in 2008, Chris and Amy Skaggs tried IVF, took steps toward adoption and then pursued IVF again before Amy was able to give birth to twins in May 2011. Though Jaxon survived, his twin sister, Leighton, died at 21 days. Using an egg donor enabled Amy to give birth to a healthy girl, Olivia, in November 2013 and give Jaxon a sister. They founded a charity, Leighton's Gift, in honor of the daughter they lost.
A year after sharing their story with CNN, the Skaggses, who live in Texas, are enjoying every minute of raising Jaxon, 4, and Olivia, 2. Jaxon is in a pre-K program and has just started gymnastics. Olivia "is 2 going on 16," according to her father, and wants to have her fingernails and toenails painted "just like Mommy."
Leighton's Gift is continuing on its quest to turn a tragedy into something positive by working closely with the Texas Health Resources Foundation to fundraise for ways to help sick babies. Last year, it was able to raise money for webcams that enable families to see their babies, even when they can't hold them.
But on the family planning side, the Skaggses still struggle. They have embryos from their donor that they are paying to keep frozen.
"There are times when we both want to have another child, and then there are times when we think we have it pretty dang good," Chris said. "Because of losing Leighton and the uncertainty of how Amy's body will react to another pregnancy, it's somewhat a roll of the dice."
Now that they have two children, it would be harder to split time between home and the hospital, so they will keep the embryos frozen for another year for now.
Sharing their story last year was almost therapeutic for the Skaggses, Chris said. Outside of close friends and family, no one else knew their entire story until then.
"Infertility is not something you just openly talk about," Chris said. "It's kind of a strange and unique club that no one really wants to be a part of. Until you start talking about it, you don't realize how many people are going through some form of infertility."
Tiffany and Todd Ray married in 2007, and after seven years of infertility treatments and five unsuccessful pregnancies, the Pennsylvania couple adopted their daughter, Kassidy.
A year later, the Ray family is thriving. They celebrated Kassidy's third birthday, as well as the anniversary of her adoption, in March. According to Tiffany, Kassidy loves anything to do with the Disney movie "Frozen" and her school. She has started taking ballet lessons, and the family took its first beach vacation.
Meanwhile, the Rays want to give Kassidy a sibling and are working with an adoption agency in Pittsburgh. They are hoping to be able to adopt within the next year after being certified to adopt both through foster care and private infant adoption.
Tiffany believes that infertility does not receive enough attention. She said health insurance companies, employers and the government need to address the disparity in coverage for fertility treatments.
"No one asks to struggle to become pregnant, just like no one asks for a disease," Tiffany said. "My hope for the future is that more women have the opportunity to be treated for infertility or build their family through adoption."
After sharing their story last year, the Rays enjoyed being able to connect with others about the journey.
"We want families to know that they are not alone and that there is light at the end of the tunnel," she said.
Nikki and Matt Cobleigh's battle with infertility began in 2009. After years of failed IUIs and IVF treatments, the couple found a surrogate, Angela Haymond. She gave birth to their twins, Lily and Kai, in March 2014.
The Cobleighs' favorite thing has been watching Lily and Kai's distinct personalities emerge and the way they interact as twins.
Kai loves hugs and wouldn't mind if someone were holding him all day. He is also a fan of singing songs like "Happy Birthday," "Itsy-Bitsy Spider" and "Wheels on the Bus." He especially enjoys making his parents laugh, like offering his mom a pretend cup of coffee and dumping it upside-down, exclaiming, "Oops! Dump!"
Lily, on the other hand, is more independent. Nikki thinks of her as feisty and brave. She likes to speak her mind and help out by cleaning up. Lily is also incredibly active, climbing, dancing and playing with a soccer ball.
They're being raised to speak Spanish and English, but they seem to have developed their own language. They are always spontaneously hugging and holding hands while going to and from preschool.
The Cobleighs live in California, and Angela, the surrogate, lives in Utah, so they don't see each other as often as they used to. But the families, including Angela's two sons, have bonded. They exchange photos and texts throughout the year and made it an annual tradition to view the Christmas lights together at Temple Square in Salt Lake City.
Angela began a surrogacy journey with another couple, but it hasn't been easy. The first transfer in October ended with chemical pregnancy, and in December, all of the frozen embryos died when thawed. After taking a break to harvest more embryos, Angela is now thrilled to be six weeks pregnant.
"It's been such an emotional roller coaster, and I feel as if I've had some insight into how heartbreaking infertility is," she said.
The Cobleighs still have three frozen embryos, but they haven't made a decision on whether to grow their family. For now, they are keeping the embryos in storage.
"Life has been chaotic and yet manageable and filled with lots of laughter," Nikki said. "As hard as the journey was, and as hard as it is being a working mom of 2-year-old twins, I wouldn't change anything."