Infertility
Involuntary childlessness
Infertility means that pregnancy has not occurred after 12 months or more of regular, unprotected sex
Approximately 8–12% of couples of reproductive age are affected. Often, doctors look for the cause in people with a uterus, but people with a penis are also responsible for 50% of infertility cases
Causes
People with a uterus
In people with a uterus, this can be caused by menstrual cycle irregularities, hormonal imbalances, or problems/diseases of the reproductive organs
People with a penis
In people with a penis, there may be issues with sperm production or quality, hormonal imbalances, or genetic causes
Sexually transmitted infections, medications, chronic health conditions, and lifestyle factors also play a role: smoking, alcohol, being overweight, and a lack of exercise can all contribute to reduced fertility.
Diagnosis
The diagnostic process for infertility is a clearly structured plan for both partners that can usually be completed within a few menstrual cycles. Identifying the causes can be stressful and require a lot of time and energy. Important to note: each person has the right to comprehensive information, counseling, and participation in decision-making
After 12 months of unsuccessful attempts to conceive, the diagnostic process can begin. It includes:
- A detailed medical history
- A gynecological and andrological (health of people with penises) examination
- Examination of the “female” reproductive organs and the sperm
If the results of these examinations are normal, doctors refer to this as “unexplained infertility.”
Treatment
In some cases, treatment initially involves making lifestyle changes, such as quitting smoking or losing weight. After that, there are other treatment options available, such as hormone therapy or assisted reproduction. If the condition is due to anatomical factors, surgery may also be considered.
These treatments can be emotionally taxing, and the chances of success vary from person to person. In some cases, pregnancy is not possible despite treatment. Here, too, it helps to seek advice and support from partners or experts.
Emotional burden
Important: Unwanted childlessness is not a sign of personal weakness
Infertility is a heavy emotional burden and is often accompanied by depression, anxiety, stress, feelings of guilt, as well as relationship and social problems.
Sexuality
Sexuality can be linked to performance pressure, thereby impacting closeness and intimacy. Some couples experience pressure and conflict as a result, while others feel a stronger emotional bond. It is possible to seek counseling as a couple to help enjoy a fulfilling sex life.
Stigmatization
Infertility is heavily stigmatized, especially for women, and affects both self-image and social standing.
- Unterstützung und Beratung gibt es beispielsweise bei der profamilia
profamilia 
- Unterstützung und Beratung gibt es beispielsweise bei der profamilia
Possible alternatives
When it comes to infertility, there are various options and paths that can be considered depending on your personal situation, wishes, and circumstances. The important thing to remember is that there is no “right” or “wrong”—only individual decisions.
Medical and reproductive alternatives
- Additional or different forms of fertility treatment (e.g., changing methods)
- Use of sperm or egg donation (depending on the legal framework)
- Embryo donation (depending on the country)
- Deciding for or against further medical treatment
Social parenthood
- Adoption
- Foster care (temporary or permanent)
- Co-parenting arrangements (shared parenting without a romantic relationship)
Living without children of your own
- A conscious decision to live a child-free life
- Focusing on other fulfilling aspects of life (relationships, friendships, career, community involvement)
- Acceptance as an active process, often involving the work of grieving
Being close to children without being a parent
- Close relationships with nieces/nephews, godchildren
- Volunteer work with children or teenagers
- Mentoring programs
Psychosocial support
- Couples or individual counseling to aid in decision-making
- Support through self-help groups
- Support in the process of letting go of the desire to have children
It is important to emphasize that alternatives are not “substitutes,” but rather distinct and valuable life paths.
Decisions are allowed to change over time.
Grief, doubt, and ambivalent feelings are normal and legitimate.