Unfulfilled desire to have children – between hope and despair

For many couples, the desire to have children of their own is an elementary part of their relationship. Many men and women only see their relationship as complete with a child; as a rule they are also confirmed in this by their environment. Most do not worry about the fact that they may not be able to realize their desire. But an estimated 15 to 20 percent of all couples in Germany cannot have children.

The cause of childlessness cannot always be determined

The search for the causes of their unwanted childlessness remains unsuccessful for many a couple: While medicine knows numerous reasons for infertility in men and women, no reason can be found in around a third of all couples. Even when the cause can be identified and treated, couples often experience a physically and emotionally draining journey from one doctor to the next.

Step-by-step root cause analysis

Irrespective of whether  sterility  (no  pregnancy  despite regular unprotected intercourse within 2 years) or  infertility  (any disruption in fertility or no pregnancy despite regular unprotected intercourse within 1 year) is being discussed, an examination and possible treatment are usually carried out A kind of step-by-step plan is followed, which successively queries and examines various points.

At the man:

• external  sex organs  (testicles, epididymis)
• previous diseases such as urinary tract infections,  mumps ,  prostatitis
•  Genital and abdominal surgeries
• varicose veins
• Problems with erection and ejaculation
• Evidence of human genetic factors such as hereditary diseases in one’s own family
• stress  at work
• family pressure
• sexual habits

For the woman:

• previous  contraceptive methods
• Irregularities in the cycle by determining the basal body temperature curve over 2 months
• Knowledge of the fertile days
• hormone analysis
• Special examinations of the uterus, ovaries and fallopian tubes
• Abdominal surgeries/diseases
• suspected pelvic inflammatory disease
• Rubella antibody status
• previous pregnancies

By both:

• sexually transmitted diseases
• psychotherapeutic experiences
• psychiatric pre-treatments

Researching the causes of involuntary childlessness is exhausting and time-consuming; the outcome uncertain. In addition, infertility in Germany   is not regarded  as a family medicine task , but men and women are treated separately by the respective specialists  ( gynaecologists , urologists, andrologists).

According to a current study by the University of Göttingen, many couples who are involuntarily childless would like to have a single medically competent contact person who collects the individual test results and coordinates the further treatment steps. In the context of the current changes in the healthcare system, it would be conceivable that family doctors could take on a role as coordinators and mediators.

Psychological care

Targeted psychological support as early as possible makes sense in any case for dealing with unwanted childlessness   . Many couples find their childlessness extremely stressful and suffer as a result. Focusing on the question “why can’t we have a child” prevents dealing with possible problems in the relationship.

In the vicious circle of tense desires, failed attempts and unfulfilled longing, massive stress sometimes arises  .  However, the stress hormones  adrenaline  and noradrenaline also interfere with the balance of the sex hormones and  additionally reduce fertility.  After all, no one can say which came first: suffering from childlessness or childlessness out of grief.

However, tying personal well-being and self-esteem so closely to a child is dangerous. The partnership soon takes second place to the child, and other interests can neither be nurtured nor developed.

Advice is necessary

Since 2000 there has been a counseling network for children in Germany, in which counselors have come together to support couples without children. Advice and opportunities for discussion are also available from Pro Familia and the welfare associations, among others.

The aim of the counseling is to provide support in  accepting the involuntary childlessness.  This acceptance does not mean resignation or giving up. Rather, it should enable a reorientation and make it clear that life without children is possible and, above all, worth living.

Couples who  choose reproductive medicine procedures  need psychological support just as much as those who give up their dream of having a child. Anyone who decides on artificial insemination or in-vitro fertilization will be informed about the risks and dangers. As a rule, however, the desire to have children and the success of the treatment are in the foreground.

The possibility of being able to conduct qualified crisis talks during this treatment should definitely be exhausted. These discussions help to cope better with the often intense pressure, especially from family and friends. Opening up to the outside world, actively communicating your desire to have children and your own suffering are an important step towards overcoming grief and stress.

consider alternatives

The role of foster or  adoptive parents  can also be an alternative and should be discussed. In the case of numerous couples, this reorientation led to the decisive inner impetus and lifted all emotional blockages: the desired child was announced only a short time later.