Problems getting pregnant – what can you do?
Hope, excitement, disappointment – and sometimes desperation: trying for a baby can be an emotional rollercoaster for many couples. Find out about what can cause a difficulty trying to conceive, where you can get help and which treatments are available.
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Short and simple
Some couples cannot have children.
There are many reasons for this.
These include illnesses and age, for example.
There are various treatments for couples who want to have a baby.
It is important to get help.
Causes of infertility: risk and influencing factors
Women who are unable to conceive often ask themselves why they cannot get pregnant. There are many different reasons why couples can have difficulty conceiving. In around a third of cases the cause involves the man, in a third the woman and in a third both the man and the woman.
Complete infertility is rare. In most cases, the fertility of one or both people involved is merely impaired.
Possible causes in women:
- Low number of eggs in the ovary
- Damaged or blocked fallopian tubes
- Organic causes in the uterus (e.g. malformations, benign tumours or growths, also known as myomas and polyps)
- Hormonal disorders (e.g. thyroid dysfunction, polycystic ovary syndrome (PCOS))
- Endometriosis (available in German, French and Italian)
Possible causes in men:
- Hormonal disorders (e.g. hypogonadism – low testosterone with impaired sperm production, excessive oestrogen levels)
- Absence or insufficient quantity of sperm in semen
- Abnormal shape (morphology) or restricted motility (ability to move) of the sperm
- Severe congenital conditions or diseases that occurred later in life (e.g. genetic disorders or infections) and the consequences of their treatment (e.g. radiation therapy)
Sometimes there is no obvious medical reason why a couple is unable to conceive. In addition to physical causes, the individual’s lifestyle can also affect fertility. The age of the woman is also a factor. Women over the age of 35 are less likely to get pregnant naturally because the number and quality of eggs decrease with age.
What influences fertility?
Unable to get pregnant? A healthy lifestyle can improve your fertility. It is important to get sufficient sleep, eat a healthy, well-balanced diet, take regular exercise and maintain a healthy weight (body mass index of between 18.5 and 25 (available in German, French and Italian)). Factors such as excessively high or low weight, smoking, excessive or regular alcohol consumption, stress and psychological issues can have a negative impact on fertility.
By paying attention to your health, you can increase the likelihood of conceiving. Would you like to find out how you can integrate healthy habits into your everyday life? The article «Trying to get pregnant? Here’s how to increase your chances» provides a wealth of useful tips.
What if you still cannot conceive?
Depending on age, the probability of conceiving within one cycle for healthy couples having regular sexual intercourse is between 10% and 30%. It is therefore entirely natural for it to take several months to achieve pregnancy. Both parties should nevertheless get support at an early stage and arrange for diagnostic tests:
- If pregnancy has not been achieved after one year, despite regular sexual intercourse.
- If the woman is over 35 and has not become pregnant after six months of trying.
- In the event of known pre-existing conditions or a history of multiple miscarriages.
Where can I get help if I am unable to conceive?
Careful evaluation of both partners
Basic tests for women:
- Hormonal analysis of the blood
- Examination of the fallopian tubes: are they blocked?
- Vaginal ultrasound to check uterus and ovaries
Basic tests for men:
- Spermiogram to analyse sperm quality
- Hormonal analysis of the blood
- Physical examination to check reproductive organs
Treatment options for couples who are having difficulty conceiving
The distress and doubts and the questions that arise when a couple is unable to conceive can cause a lot of emotional strain. Infertility treatment can give hope but it is also a challenging process. It can be exhausting and time-consuming and generally demand a lot of the couple. However, you are not alone during this period of emotional strain – talk to people or seek professional support. You can find recommendations for this further down this page.
Modern reproductive medicine offers many options. The treatment is always tailored to the couple’s individual situation. Talk to your doctor to work out which method is the right one for you.
Hormonal treatment involves administering a hormone injection to stimulate ovulation and then monitoring the ovulation process via ultrasound scans and blood tests. If the follicle is large enough, ovulation is triggered with a further hormone injection. Fertilisation then takes place either via sexual intercourse or via intrauterine insemination – the injection of prepared sperm directly into the uterus.
With intrauterine insemination (IUI), the medical professional inserts the sperm directly in the uterus. This increases the likelihood of fertilisation occurring. In addition, the woman is often given hormones to stimulate ovulation. Her cycle is monitored closely. Once the follicle is large enough, another hormone injection is given to trigger ovulation. Next, the man’s sperm is ‘washed’ in the laboratory to ensure that as many motile sperm as possible can be introduced into the uterine cavity at the optimal time.
IUI can be performed during the normal cycle or in combination with hormone treatment.
With this method, fertilisation occurs outside the uterus. Firstly, the woman is given hormonal treatment to stimulate the release of multiple eggs into the ovaries. The mature eggs are then removed from the ovaries, and the eggs and sperm cells are mixed together in the laboratory. If fertilisation is successful and the fertilised eggs continue to develop, the embryo is inserted into the uterus after a few days.
Artificial insemination methods
The two best-known artificial insemination methods are called in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI). The difference between IVF and ICSI is in how the egg is fertilised. In IVG, multiple sperm cells fertilise the egg by themselves, whereas with ICSI, a single sperm cell is injected directly into the egg with a glass micropipette.
Cryoconservation
As part of the artificial insemination process, unused embryos, eggs and sperm cells can be frozen in order to be used at a later date.
The psychological burden – you are not alone
Infertility can be very stressful for those affected. Many people feel disappointed and sad or lonely because their desire to have a family has not be fulfilled. Feelings like this are completely normal and understandable. It is important that you do not keep them to yourself. Talk to your partner, family or friends about how you are feeling. Professional support can also help you to cope more effectively with this intense period of your life.
The CONCORDIA mental health check can offer guidance on coping with the mental burden.Other points of contact and advice centres
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Points of contact
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Advice centres
