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Unfulfilled desire to have children

According to the definition of the WHO (World Health Organisation), a couple is considered sterile, if the woman does not become pregnant within one year with regular, unprotected intercourse.

In individual cases, however, this does not say much about the actual chances of giving birth to a child. Every third woman who wishes to have a child waits more than a year for a pregnancy. Even in case of a healthy couple, the chance of becoming pregnant during regular intercourse within one cycle is only 10 to 30 percent depending on age, as fertilisation does not take place during every intercourse. Less than 5% of all couples in Germany remain childless permanently and unintentionally.

Fertility is not a static thing. Even young people can experience fertile and infertile phases due to mental and physical overload or an unhealthy lifestyle. Whether and when a couple should undergo naturopathic or reproductive medical treatment is up to each woman and man to decide for themselves. Medical and psychosocial counselling can be helpful in the decision-making process.


Physical causes

In addition to physical causes, stress, alcohol and nicotine can also have a negative effect on fertility. However, certain medications can also affect your fertility. A connection between nutrition and fertility has been researched up until now mainly for women. Psychological stress and problems can also affect fertility. Internal conflicts and fears can be involved in infertility problems.

The physical causes of unwanted childlessness include, among others, the following in women:

  • Disorders of ovarian functioning
  • Hormonal disorders of the pituitary gland, thyroid gland, adrenal cortex *physical illnesses such as diabetes and infectious diseases
  • Intergrowth or other malformations of the ovaries
  • Endometriosis
  • An untreated chlamydia infection

The physical causes of unwanted childlessness include, among others, the following in men:

  • Dysfunctional testicle functioning
  • Spermatic duct occlusion
  • Immunological sterility: Antibodies against spermatozoa
  • Infections



The investigation of the causes of infertility has three objectives:

  • Determining whether ovulation takes place
  • Assessment of sperm quality
  • Checking the patency of the fallopian tubes

In addition to a general physical check-up of the concerned person, diagnostic measures include hormone determination in the woman's blood, ultrasound, microbiological examination, if a genital infection is suspected, and examination of the patency of the fallopian tubes. In men, the external genitalia is examined and the quality of the sperm is checked. If a genital infection is suspected, a microbiological check-up is carried out.

Psychosocial aspects

Psychosocial aspects of unfulfilled desire to have children

Numerous studies have now shown that couples, who wish to have children do not differ from couples in the general population with regard to psychosocial aspects. There are only a few couples for whom childlessness can be classified as psychological. These cases include extreme stress, eating disorders that lead to severe underweight or overweight or sexual disorders that prevent sexual intercourse, e.g. erectile dysfunction in men or vaginismus (vaginal cramping) in women.

The problem of having children can, however, bring phases with it that put couples under a strong psychological strain. The time of diagnosis, the sterility treatment or eliminating the possibility of having a biological child can be experienced as a crisis by man and woman.

If you are looking for support, psychosocial counselling can help.

Individual and couple counselling

  • conversation within the companionship about different experiences and ways of dealing with childlessness
  • an effort to find their own ways of dealing with expectation and disappointment during treatment
  • creatively dealing with the expectations and reactions of family, circle of friends, and colleagues
  • dealing with possible miscarriages or developing ideas on how to deal better with childlessness

Sexual counselling

  • sexual problems, e.g. loss in sexual appetite, which has developed during the phase spent waiting for a child
  • sexual problems, e.g. erectile dysfunction, which existed before this phase and which has intensified in the course of fertility treatment


Reproductive treatment options

Personal counselling

If you want to know more or have questions, please contact a doctor or a pro familia counselling centre.

Doctors, social workers, psychologists and pedagogues shall be at your disposal as contact persons.

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