Unfulfilled desire to have children - what can you and your partner do?

According to the WHO (World Health Organization), if a woman has not become pregnant after a year of unprotected and regular sexual intercourse, the couple is considered infertile.

As Profamilia explains, that doesn't mean that the desire to have children has to go unfulfilled. One in three women takes more than a year to get pregnant. In Germany, unwanted childlessness among couples is less than 5 percent. Sometimes family planning is successful with the first child. However, some parents do not fulfill their wish for more children. Therefore, it is important to know which risks can block the desire to have children.

There are various reasons why a couple can remain childless. The cause can lie in both the man and the woman. In some cases, no medical reason for childlessness can be found.

The following risk factors can have a negative impact on fertility:

• Stress in the family, at work or otherwise
• Excessive consumption of alcohol
• Sport in the performance area
• overweight
• Diet (Eating Disorders)
• Drugs
• vaginismus
• erectile dysfunction in men

Age also plays a role in fertility. It can become more difficult for women to have children after the age of 35. Fertility decreases throughout life and ends with menopause. In men, the quality and quantity of sperm can decrease with age.

• Endometriosis: This disease can cause cervical mucus to build up outside the uterus. Many affected women are therefore unable to become pregnant.
• hyperprolactinemia: If the woman's prolactin level is constantly elevated, the body could not provide a fertilizable egg cell during the cycle. Ovulation is thus inhibited. Kidney problems, a benign tumor, and medications such as neuroleptics or antidepressants can increase prolactin levels.
• fibroids in the uterus: While pregnancy may be possible with these benign tumors, there is a high risk of miscarriage.
• hyperandrogenemia: If a woman's body produces too many androgens (male sex hormones), this can also block fertility.
• Altered cervical mucus: When the mucus in the uterus changes, it can make it more difficult for sperm to survive and move.
• Too low pH in the vagina: Low acidity in the vagina can reduce the chance of becoming pregnant. In this case, not enough sperm reach the egg cells in the fallopian tube.
• disorders of the fallopian tubes: Adhesions, adhesions and other disorders negatively affect fertility.
• Defective or absent sperm: In azoospermia, sperm may be absent from the ejaculate. Either the vas deferens are closed so that the sperm cannot get into the semen or there is no sperm production. Likewise, unwanted childlessness can be due to an insufficient number of sperm. Furthermore, in some men the sperm are not mobile enough or the sperm are abnormally shaped.
• chemotherapy: Radiation or chemotherapy can reduce fertility.
• Genetic Disorders: In both men and women, a genetic change can lead to infertility. In women, for example, this can be a malformation of the ovaries. Due to Klinefelter syndrome, some men have an excess of sex chromosomes, which leads to infertility.

There may be other reasons for the unfulfilled desire to have children. First you have to find the reason. Gynecology is the first port of call for women. Men should consult their GP first.

In Germany there are fertility clinics that specialize in this topic. All relevant examinations and measures are carried out in these clinics.

Reproductive medicine offers methods to treat infertile couples. The prerequisites are examinations of the man and the woman and a diagnosis. Only when the experts have found the cause of the childlessness and this does not lead to fertility through appropriate treatment can other options be considered.

In hormone therapy, the woman takes a hormone preparation every day that can stimulate the maturation of the egg cells. The doctor checks the hormone values ​​and egg cell maturation. Egg cells are removed from the ovary under a short or local anaesthetic. The egg cells are fertilized with the man's sperm in a test tube and then inserted into the uterus.

The topic is still taboo, so few couples talk about infertility. Those affected are ashamed and afraid that their pain and grief will not be understood. They often have to justify themselves and explain why they have not yet become parents.

The results of a study by the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth make it clear how much couples suffer from the unfulfilled desire to have children. However, the study results also show that there are still many prejudices about artificial insemination.

It is not uncommon for involuntary childlessness to trigger depression and feelings of guilt. Those affected blame each other and this in turn can have a negative impact on love, relationships and sex. The internal pressure that builds up from worry and grief is a major stressor - and stress can in turn be a reason for infertility. That's why it's important for the couple to seek support so that they regain courage and hope as well as joy in life.

Sex therapy can help with sexual problems. The couples often become listless due to the psychological stress or sexual problems such as erectile dysfunction increase.

Individual and couple counseling is also recommended. In conversations with the therapist, the disappointment and expectations can be discussed.

In addition, it often becomes clear during the consultation that and how both deal with the topic and experience the unwanted childlessness. This leads to more mutual understanding. In addition, professional therapy can help the couple when they have to come to terms with childlessness.

Profamilia offers counseling centers. In addition, a free brochure on the subject of "unfulfilled desire to have children" is available on the Profamilia website.