Unfulfilled desire for children

As of what point does a couple turn into a couple with unfulfilled desire for children?

The WHO has defined that after one year of regular intercourse without contraception a natural pregnancy should have occurred. From then on the natural waiting time is exceeded. If there is no pregnancy despite a prolonged period of unprotected intercourse, it is advisable to clarify the causes. If you are older than 38 years of age, you should seek medical help after just six months and get to the root of the problem.

On this page you will find information about:

Social causes

Couples today who have their first child are on average much older than those in the past. Education and career are pushed to the forefront; the desire to have a baby is placed at the back of the line. This social development is one of the reasons why many couples take longer to get pregnant. Because fertility decreases with increasing age. The biologically best age for having the first child would be the period of 25 to 35 years. At this age, the body is the most resilient. In addition, many people deal with different risk factors as they age. Years of smoking, infections, etc. have a negative impact on fertility.

How are the causes clarified?

The clarification is gradual. For couples who turn to us, we first invite them as a first step to an initial consultation. Here we talk about:

• Previous diseases and therapies
• Current physical complaints
• Sexual behavior
• General mood in the relationship
• Importance of a pregnancy for the partnership
• Questions about the urgency of having children

Then, depending on your individual situation, we will carry out various examinations, i.e. an oviduct ultrasound (HYCOSY).

Causes in the woman

There are many causes of infertility or a fertility disorder. In women, it is often hormonal problems that cause ovarian dysfunction or egg cell maturation. The medical clarification is more complex than in men, because the female genitalia are located internally and the female body has to fulfill numerous functions in the reproduction. It not only has the task of producing the germination cells, but must also carry the pregnancy.

The most common causes of fertility disorders or infertility in women are:

• Closed fallopian tubes (tube factor)
  In about one third of unintentionally childless women, the fallopian tubes are completely or partially closed. The reasons for this are often inflammations, surgeries or ectopic pregnancies in the past.
   
• Endometriosis
  About 10% of all women are affected. The number of unreported cases is higher because endometriosis can only be ascertained beyond doubt by surgery. Endometriosis immunologically causes impaired oocyte fertilization capacity and reduced activity of the uterus and fallopian tubes (peristalsis).
  Endometriosis is divided into four stages:
  1. 80% of sufferers have stage 1 or 2. With artificial insemination, however, a pregnancy can be achieved.
  2. At stage 3 or 4, it is beneficial to perform an operation before artificial insemination.
  
  If it comes to a pregnancy and it is carried full-termn, the endometriosis disappears in 60% of women affected.
   
• PCO syndrome
  The PCO syndrome is an enzyme defect on the ovary. Numerous immature oocytes form on the ovary. Above a certain threshold level, ovulation does not occur because no dominant egg can form. 50% of women with PCO syndrome are overweight. 10% weight reduction often results in normal ovulation. The PCO syndrome is assessed using the Rotterdam criteria.
  At least two out of three criteria must be met:
  1. More than 12 antral follicles on each ovary
  2. Rare menstruation or the absence of ovulation
  3. Increased levels of male hormones
  An important diagnostic indicator is the determination of AMH (anti-Müller hormone). If the AMH is over 5 (in some laboratories also over 7), one speaks of a PCO syndrome.
   
• Anatomical causes in the area of ​​the uterus
   
• Metabolic problems and hormonal changes (eg Hashimoto's thyroiditis)

Causes in the man

In the case of a man, the reasons for an unfulfilled desire to have a baby are easier to determine. For this, a spermiogram exam is sufficient.

The most common fertility problems in men are:

• Disorders of sperm cell formation
  There should be 15 million sperm per milliliter of seminal fluid. Of these, at least 4% should be shaped normally and at least 32% should be well mobile.
• Disorders of sperm transport
  Completely or completely occluded spermatic ducts are often caused by a disturbance of the epididymal function, by scars after surgery or by unnoticed infections.
• Insufficient urinary bladder closure
  In affected men, the penis does not convey the semen outside the body during an orgasm but deposits it into the bladder.
• Antibody formation
  The immune system of the man treats the sperm cells as a foreign body and attacks them.
• Hormonal and genetic disorders

A number of different disorders can affect fertility. Also general diseases of the kidneys or the liver or the heart as well as metabolic disturbances affect fertility.

Risk factors for fertility

It is not only physical disorders that harm fertility.

A whole range of risk factors can also have negative effects:

• Mental stress
• Constant stress
• Excessive overweight or underweight
• Excessive alcohol or nicotine consumption
• Drug consumption
• Excessive sport
• Demanding  work
• Low-vitamin diet
• High radiation exposure

Having children despite that

To treat a fertility disorder, an accurate diagnosis of the causes is necessary. Depending on the situation, we then select the best treatment for you and support you on your way to the desired child. You should therefore not be discouraged from the outset. For most couples who want to have children, the right treatment and the possibilities of artificial insemination fulfill the wish of the baby.

You are unintentionally childless and want to clarify the causes for it?
Arrange an initial meeting with us. We are happy to advise and assist you.