Desire to have children
These page cover the first most pressing questions that arise when one expresses the desire to have a child, but if the success never comes - divided into three chapters. Questions regarding fertility, experience and success, as well as details on possible risks. Thus you may simply read the chapters one by one through links taking you further. Below are short descriptions of the next chapters.
Questions on fertility
Am I infertile? When does one speak of infertility?
The desire to have an own child is a fixed part of being human, and when it doesn't 'work', we need one thing above all else: helpful information and enlightenment. The second thing we need is good foundations for solutions.
One can speak of infertility if, after a year of constant trying, there is no pregnancy. This definition is also shared by the WHO (World Health Organisation), which in this way covers the altered living conditions in the industrialised Western nations, i. e. taking into account the higher mobility of the partners.
The causes of infertility can be varied between men and women, in 20%-30% of cases they are usually on the woman's side, in up to 50% of cases on the man's side, and in the remaining 20% of cases the causes can be attributed to both the male and female partner. In 10%-15% of all pairs the reason for no children being born cannot be clarified. Thus sterilisation treatment is thus always a pair treatment.
One can speak of infertility if, also after a year of constant trying by a pair, there is no pregnancy.
When you are approached by the issue of infertility, there is the possibility of having sterility advice at Fertility Center Berlin. This advice should be planned as early as possible, because already in the first conversation it can bring relief and possibly show new ways of action.
Fertility of men and women
Women are most fertile between the ages of 22 and 27, afterwards fertility is gradually drops. With the onset of the menopause, natural fertility ends.
Natural fertility in men reduces slowly from age 40 onwards, however in individual cases it can remain until old age.
Experience and successes at Fertility Center Berlin
The success of fertility therapy is determined first and foremost by the experience of the doctors supervising the treatment and of the laboratory. The team at Fertility Center Berlin has been working together already since 1999 in the same member setup. The doctors had known each other since 1991, and had executed fertility therapy already at the University Women's Hospital of the Free University of Berlin (Pulsstrasse site) and at the hospitals of the German Red Cross in Westend.
Risks associated with fertility treatment
What can happen - I want to be informed!
In order to have successful fertility treatment, hormonal stimulation and therapy is usually required. This leads to follicle cell growth and in rare cases can lead to overstimulation. Overstimulation can occur alongside size increases of ovaries, fluid accumulation in the abdomen and stronger or milder pains in the lower abdomen. In rare cases one can experience shortness of breath or thrombosis. Overstimulation is very rare in cases of conventional fertility therapy (pure hormonal stimulation or semen transfer). It arises most often in cases of stimulation in preparation for in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI). If you should experience overstimulation, then you should always consult a gynaecologist for assessment.
A further point of risk of the treatment is the emergence of a multiple pregnancy. Higher order multiple pregnancies (triplets or more children) are very rare, and may arise after conventional fertility treatment in <1% of all cases. After in vitro fertilisation they also occur less often now than they did previously, because in women under 40 years usually only 1-2 embryos are transferred. In women aged over 40, the individual possibility that all of the maximum three utilised embryos are nested is even less probable so that in their cases one can usually transfer also three embryos. A pregnancy of triplets carried to term in a woman aged over 40 hasn't occurred at Fertility Center Berlin for the past 7 years.
Further risks, i. e. the growth of abscesses or bleeding after interventions like the vaginal follicle punction, are very rare and can arise with a probability of about 1:500.
In children born via the ICSI method the probability of malformations can reach 9%. The German ICSI follow-up research study had compared 2800 children who were born after fertilisation with the ICSI method, with 2800 children selected at random. According to the study, the risk of the ICSI group for malformations lay at 9%, whereas for the randomly selected group such a risk was assessed at 7,2%. Thus one should take into account that the risk of malformations after ICSI is slightly elevated. We believe, however, that this risk is only elevated in a limited scope, and that it should not be considered a contraindication for fertility treatment.
Causes for women
An unfulfilled wish for a child - is it up to me?
Women special: unfulfilled desire to have childrenThe causes of unfulfilled desires to have children only in 30% of cases rest solely with the woman. In 50% of cases the man is solely responsible, and in a further 20%, both partners may be responsible.
Fertility Center Berlin supports you in the clarification of the cause in your personal case. We will discuss all questions discretely, we will conduct a precise diagnosis, in order to develop, as required, a treatment plan for you - in close cooperation with specialist doctors or any doctor you trust.
Reasons for unfulfilled desires to have children in women could be:
- blockage of the fallopian tubes (tubular sterility)
- carryover of the mucous membranes of the uterus into the free abdominal cavity (endometriosis)
- hormonal fluctuations with too many male hormones and absence of ovulation (PCO or PCOS)
- premature ageing of ovaries
- failure of the pituitary gland, lack of stimulation of the ovaries
- and many more reasons...
According to our experience, a high percentage of the reasons is premature fatigue of the ovaries, which can, in many cases, occur quite early. In many women beginning at 38 this fatigue of the ovarian reserve gets stronger. This can be measured using the Anti-Müllerian hormone (AMH), which can give a direct answer as to how much the ovaries are still functional, and what are the chances of fertility therapy.
The Anti-Müllerian hormone (AMH) is secreted by the ovaries or the testes. It measures directly the number of small egg follicles in the ovary, thus directly the ovarian reserve. In women during the menopause, the Anti-Müllerian hormone has a value under the detection limit. In women with an increased ovarian production (i. e. like the polycystic ovary syndrome (PCO), the value is increased. The AMH is the earliest marker by which premature exhausting of the ovarian reserve can be determined.
Causes for men
What men should know
Over 50% of causes of unfulfilled desires to have children lie with the man - this cannot be doubted. But in every case it is prudent to make use of possibilities offered by Fertility Center Berlin: We will speak with you about the possible causes, we will execute thorough diagnoses and in the end a cause examination - and we will create your treatment plan in cooperation with specialist doctors.
Infertility in men
The most often experienced cause of infertility in men is reduced sperm quality. There can be several reasons for this situation, including as follows:
- hormonal dysfunctions
- varicose veins in the testes
- abnormal location of the testes
- mumps experienced during childhood
- tumours that had been operated on
- genetic causes
- drug and alcohol abuse
Reduced sperm quality
There are many types of reduced sperm quality: oligozoospermia, asthenozoospermia, teratozoospermia, cryptozoospermia and azoospermia. These can occur individually, or in combinations.
- oligozoospermia: the sperm count in the semen is too low (norm: >20 million sperm/ml)
- asthenozoospermia: the mobility of the sperm is reduced (norm: >50% mobile sperm)
- teratozoospermia: in the semen there are too few normally formed sperm (norm: >15% normally formed sperm)
- cryptozoospermia: there are only a few sperms present in the semen
- azoospermia: the semen has no sperm at all.
If the examination of the semen shows no abnormalities, and if all values are within normal ranges, then this condition is called normozoospermia.
After thorough diagnosis at our centre (spermiogram and blood examination), there follows a search for causes and planning of the treatment in close cooperation with appropriate specialist doctors (human geneticists and urologists), if this seems necessary.