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Unfulfilled desires

The yearning for a baby is deeply engrained in humans. Pregnancy and birth of a child are the greatest adventures in a woman’s life. Sadly, for about every 7th couple this desire remains unfulfilled.

The WHO defines sterility as when pregnancy does not arise for a year whilst having regular unprotected sexual intercourse. Possible causes should be clarified then at the latest. The team of doctors at Woman & Health aids couples with such unfulfilled desires.

Causes: Statistically speaking, the causes are found in about 30 to 40 percent with either partner. In 15 to 30 percent both partners are responsible. And about 5 to 10 percent, no real cause is found.

Since the unfulfilled desire to have children affects both partners, the search for causes and the treatment of such should always happen in concert.

Female causes

Reduced reserve of egg cells: A woman’s age is the most important factor in these matters. Around the age of 35 the female fertility starts to slowly fade.

At birth the female body is equipped with about one million (still premature) egg cells, but at the age of sexual maturity this number has decreased to about 250,000 cells. Every year the reservoir shrinks until no fertile egg cells are left.

hormonal disorders: hormonal imbalances can impair the maturing process of egg cells, disrupt ovulation, inhibit nidation, and lead to repeated miscarriages, among others.

Frequent hormonal disorders are

  • Polycystic ovary syndrome (PCOS)
  • dysfunctional thyroid glands
  • hyperprolactinaemia (abnormally-high levels of prolactin)
  • increased levels of male sex hormones
  • early menopause

A blood count helps in diagnosing these and other hormonal disorders.

Abnormally-low body weight as well as extreme changes in weight over a short period of time can definitely lead to dysfunctional ovaries. Also, hormonal imbalances can result from prolonged professional or competitive sports as well as extreme physical or psychological stress.

Dysfunctional oviducts: About 25 percent of all infertile women suffer from an occluded or damaged oviduct. Frequent causes include an earlier infection of Chlamydia, a rather subtle disease, often without any appreciable symptoms.

Different methods such as x-ray and laparoscopy are used to determine the state and possible obstructions of the oviducts.

Endometriosis: About 30 % of all sterile women suffer from endometriosis. Mucosal cells appear and flourish in areas outside the uterus, most commonly on the ovaries. It can be diagnosed through laparoscopy. Treatment is not permanent and usually improves fertility for about one year.

Male causes

Male factors are causes in about 40 percent of all couples with the unfulfilled desire to have children. Thus the examination of fertility in the man is just as important as in the woman.

These three criteria are important when analyzing the male sperm in a spermiogram:

  • Concentration
  • Motility
  • Shape

For proper results it is recommended to restrain from sex or masturbation for a period of 2 to 7 days before conducting the spermiogram. This is necessary because the sperm count is reduced after sexual activities; waiting too long however, while increasing the count, is detrimental to the sperm’s motility.

Important: There may be extreme fluctuations in the quality of the sperm; therefore it is recommended to undergo 2 to 3 examinations before poor sperm quality is diagnosed to cause sterility. In case of other abnormalities discovered in the spermiogram a urologist is to be consulted.

Fertility: The WHO defines sterility as when pregnancy does not arise for a year whilst having regular unprotected sexual intercourse. Possible causes should be clarified then at the latest.

Age is an important factor to consider when planning to have children, as the egg cell count decreases with the years: Women between the ages of 25 and 35 have a 70% chance of becoming pregnant during one year, whilst there is only a 20% chance for women between the ages of 35 and 40.

Therapies become less effective with increasing age as well. Thus a fertility check should be performed after a shorter period of time (about 6 months) for women over the age of 35.

All examinations (including a comprehensive blood test and the vaginal smear) are conducted at Woman & Health.