Contributing Factors

Most people take fertility for granted and are more worried about an unplanned pregnancy than of not being able to have children.

When a planned pregnancy does not happen, it is usually the woman who first senses an increasing pressure to perform, a sense of failure, an almost insult to her self-esteem. Coping with these pressures can be difficult if she feels unable to discuss her problem with others. Out of shame or guilt, she may believe she has to keep the problem a secret and might even try to ignore it or deny it. The curiosity of friends and relatives regarding parenthood can place even more pressure on her and her partner.

Thoughts can become concerned primarily with the issue of reproduction and can reduce sexual intercourse to a planned occurrence only during ovulation. By reducing sexuality to this level, it loses its spontaneity, and the playful, lustful and affectionate feelings give way to a scheduled performance of duties.

This becomes an additional burden for the relationship in the long run, and the couple can come to the point where they believe they cannot manage without help any longer. If the time has come for medical help, the woman will usually see a doctor first. The physician will inform her that her partner may have limited fertility as well, which sooner or later leads to his medical examination. Already this step of investigation and a first treatment could have a positive effect on the couple, because they are no longer alone and help is within reach.

If results of examinations or previous treatment show that there is no or almost no chance of having a child naturally, artificial fertilization methods may be considered. This step takes courage since many people associate artificial reproduction with unfamiliar and sometimes frightening procedures, such as 'test tube babies', 'gene manipulation', etc., or consider the treatment too cumbersome or too expensive and see little chance of success.

Therefore, it is not surprising that many couples who decide to use artificial reproductive technologies are scared at first. To calm these fears, it is essential to build a climate of confidence between the doctors and the patients and to provide sufficient information about the treatment. An additional necessity for successful treatment is a treatment plan, which can be understood by both the medical staff and the patients.