Reasons for unwanted childlessness

For most couples the desire for children is fulfilled naturally. However, about 15-20% of all couples remain involuntarily childless.

In 45% of cases the underlying cause can be assigned to female problems, in 45% to male problems. Couples are often faced with a combination of male and female reproductive problems. For an ever decreasing percentage of couples (due to continuous improvement in diagnostics) the reasons are not clear (this is referred to as idiopathic sterility).





Involuntary childlessness can have various causes, such as hormonal imbalance, pathological changes of human organs and serious illness. Moreover, it is often due to an unhealthy lifestyle.

1. Disorders in development of ovum and sperm
2. Problems with the fusion of egg and sperm
3. Problems arising after fertilization
4. Same sex partnerships
5. Single women

The reason for infertility may be that no oocyte (oogenesis) or not a sufficient number of sperms (spermatogenesis) reach maturity. If no oocyte matures, this is mostly due to a malfunction of the endocrine system with its endocrine glands (hypothalamus, pituitary gland, ovaries etc.). The underlying endocrine problem has to be determined by doing hormone analysis and eventually being treated appropriately.

The presence of spermatozoa is assessed by a microscopic examination of the semen sample.

Many millions of motile spermatozoa are necessary for the successful fertilization of an oocyte. However, only a few of them will actually reach the fallopian tube. Within the fallopian tube the oocyte has to be surrounded by several hundreds of sperms for fertilization. Too few mobile sperms will result in a failure of fertilization. It is rare that sperm abnormalities are only caused by hormonal deficiency, but more frequently by a defect in the testicles themselves, which are more difficult to treat (compared to problems with the egg ripening process in women).

The diagnosis of male infertiloty requires special tests. Treatment with drugs or hormones may be tried in order to improve number and quality of mobile spermatozoa. Currently, there are hardly any treatment options for neither testicular degeneration nor genetic disorders that may affect the testes. 

Even if there is a mature oocyte (oogenesis) and sufficient mobile spermatozoa, there is still a multitude of factors that may inhibit the fusion of ovum and sperm (fertilization). Tubal blockage preventing gamete fusion accounts for the majority of cases.

These include adhesions in the fallopian tubes as a result of infections, adhesions between the tubes and ovaries, absence of the tubes as a result of previous surgery as well as tubal obstruction after sterilization.

In some very rare cases immunological processes in the cervix ( neck of the uterus) can impair the motility of sperm cells.

The early embryo might die before implantation (or nidation) due to either inherited or acquired developmental deficiencies. Furthermore, implantation may fail, because the lining of the uterus (endometrium) is not properly prepared. In some cases the mother's immune system may identify the embryo as exogenous protein and reject it.

Unexplained fertility is also referred to as idiopathic sterility. In these cases, it is important to be aware of psychosomatic components, for emotional issues can have a major impact on the human body. Therefore, psychological aspects should be evaluated in order to take the necessary steps to improve the chances of conceiving.

Being part of a network, we are looking forward to helping women who are in a partnership with other women to take advantage of all currently available treatment options (Insemination, IVF, ICSI, IMSI).

Enabled by this network, we also offer single women all currently available treatment options (Insemination, IVF, ICSI, IMSI).