Healthy couples can have fertility problems
Factors Affecting Fertility
In medicine, a couple is referred to as sterile or sterile if they do not become pregnant within 1-2 years despite regular sexual intercourse. One speaks of primary sterility if conception has never occurred, of secondary sterility if at least one pregnancy has preceded it, regardless of whether it was carried to term. In Germany, ~ 15% of couples are involuntarily childless. 30% of the causes lie with the man, 30% with the woman and 30% with both partners; in 10% the causes remain unexplained, which is referred to as idiopathic sterility. Often the sterility is about temporary Fertility disorders that can in principle be treated. Complete sterility, on the other hand, is seldom the case, for example if the man does not produce any sperm cells or the woman's uterus has been removed.
Infertility denotes the inability to successfully carry a pregnancy to term (for example, when repeated miscarriages occur); however, the term is often equated with sterility, i.e. the inability to father a child.
During fertilization, the sperm cells penetrate the cervical mucus and continue to swim into the fallopian tubes. The matured egg cell is released into a fallopian tube, where the fastest sperm cell enters the egg cell with its head. The fertilized egg travels further into the uterus, where it nests in the lining of the uterus. Each of these steps can be disrupted and thus be a possible cause of infertility.
Georg Thieme Verlag, Stuttgart
The right time. In order to get pregnant, it is useful to know the time of ovulation. After ovulation, the egg cell remains capable of fertilization for ~ 24 hours, and sperm survive in the woman's body for up to five days. The optimal period for sexual intercourse begins two days in front ovulation and ends a day after. Those who previously used contraception with the "pill" need an average of a few months longer to become pregnant. But even without contraception, the chance for a (healthy) couple with regular sexual intercourse is only ~ 25% per month. Waiting times up to one Year are therefore still normal.
The biological clock. The best age to become pregnant is for women between the ages of 20 and 30; From 30 onwards fertility drops slightly, from 35 onwards significantly and from 45 onwards the probability of becoming pregnant is almost zero. The decisive factor for how long a woman can have children is how much egg cells are stored in the ovaries. While a woman has a million immature egg cells at her birth, the number drops to around 25,000 by the age of 37. The number of egg cells with chromosome damage increases. Nevertheless, more and more women do not decide to have a child until they are 30. One of the main reasons for this can be seen in the generally longer training periods and the changed living and working conditions of women today: child, career and partnership must be reconciled. But when the head finally says "yes", the body often objects. It is not uncommon for them to go to a center for reproductive medicine. On the other hand, there have always been late mothers whose children were born without any problems Many risks can be statistically recorded for the children of older mothers, but they are not dramatically increased. The discussion about late motherhood, which is sometimes reproachful in the media, should not be overestimated in the personal decision of a couple. After all, no one sets an age limit for men either In principle, they can be procreative until the end of their life. However, the number of fertilizable sperm cells decreases from the age of 40. Another problem is the erectile dysfunction, which increases with age.
Stress. The most important control centers for reproduction are located in the brain and are extremely sensitive to external influences. Pressure at work or unemployment, financial worries, partnership conflicts, exams, deaths in family or friends - all of these can lead to menstrual disorders in a woman, suppress ovulation and inhibit semen production in men, even if this factor is difficult to quantify. Of course, stress cannot (always) be avoided, but it is important to create a balance through physical exercise, a healthy diet and relaxation.
"Procreation stress". For many couples, the unfulfilled desire to have children creates a great emotional burden. Often both partners are frustrated when a pregnancy does not occur even though they have done everything to ensure it. This negative mood and the increasing pressure of expectation ensure persistent stress and inner unrest. It is important, albeit often not easy, to simply approach the problem with more composure. Making all of your happiness dependent on having children fulfilled often has exactly the opposite effect.
Tip: Don't tell your friends and families if you are planning a pregnancy. In this way, you avoid the inevitable queries that put you under even more pressure.
Diet and weight. Both severely underweight and severely overweight women often suffer from fertility problems. If you consume fewer calories than you need, the organism slows down the burning of nutrients and cuts down those bodily functions that are not absolutely vital, such as reproductive capacity. The monthly cycle can stop after just two weeks without a steady increase in food. In the case of very overweight women, on the other hand, the estrogen balance is disrupted by the estrogen production of the fat cells, and this excess of estrogen also reduces fertility.
The composition of the food also plays a role. A very high-carbohydrate, vegetarian diet leads to menstrual disorders more often than a balanced Mediterranean diet.
It is still unclear whether men’s reproductive capacity is influenced by their body weight and appropriate diet.
Environmental influences and competitive sports. In men, strong heat or overheating of the testicles affects z. B. through intensive cycling or wearing (too) tight jeans have a negative impact on semen production and quality. In women, too, competitive sport, or rather continuous intense physical exertion, can result in the absence of menstrual bleeding or ovulation. Constantly high noise levels also seem to have a negative impact on woman's fertility. Industrial pollutants and environmental toxins such as heavy metals or pesticides also damage fertility in principle.
Alcohol. High alcohol consumption affects fertility in both men and women. Alcohol-dependent women unfortunately often suffer from menstrual cycle disorders, while in men, in addition to potency, sperm production and mobility are also reduced. However, the disorders normalize after three months of abstinence.
Nicotine. Smoking also affects the sperm count and mobility of men. In women, smoking too much reduces the conception rate and increases the risk of miscarriages. Here, too, the situation improves after several weeks of weaning.
AuthorsDr. med. Andrea Stadler, Dr. med. Arne Schäffler in: Gesundheit heute, edited by Dr. med Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). | last changed on at 13:27
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