Unfulfilled desire to have children - data and facts

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Childlessness is rarely planned. A survey by the Allensbach Institute for Demoscopy revealed that only eight percent of Germans make a conscious decision not to have children. Despite the desire to have children, one in five couples does not become pregnant - and this even applies to parents who already have one child and want another. In total, the institute reckons with 1.4 million Germans who are involuntarily childless.

In most cases there is a physical cause behind the lack of pregnancy. It is somewhat more common in men than in women, but it also regularly affects both partners. Fertility may only be temporarily impaired, for example due to illness, stress or eating habits.

Put on the back burner

A natural limit to fertility is age. With an average of 52 years, women in the western industrialized nations go through menopause - hormonal changes make pregnancy afterwards impossible. But the chance of giving birth to a healthy child has already declined a few years beforehand: at 35 it is only half as high as at 25. The biological clock is not only ticking for women: beyond the age of 30, fertility also decreases Men gradually return.

Experts attributed the decline in the birth rate of recent years to an increasingly late decision to have a child. Adjusted figures from the Federal Statistical Office in Wiesbaden from 2006 showed, however, that women with their first child are hardly older than they were 50 years ago. Women who are now 72 to 77 years old became mothers for the first time on average at the age of 25; the age of now 62 to 66 year olds fell to 23 years and then rose again for women who are now 46 to 51 years old for 26 years.

Birth of fertility centers

The slightly older age of today's mothers is also due to medical progress, with the help of which older women are increasingly able to fulfill their desire to have children. According to data from the Berlin Institute for Population and Development, couples now seek medical advice more quickly if pregnancy does not succeed naturally. After an average of 1.6 years of fruitless attempts, the majority of men and women resort to the help of reproductive medicine.

And that has improved a lot since the first German baby was born after artificial insemination in 1982: around 120 fertility centers and various practices and clinics now look after childless couples.

More than four percent of current parents have made use of this support. Every year 12,000 children in this country see the light of day after in vitro fertilization (IVF). This corresponds to 1.6 percent of all births. In 2003 this number soared to the previous high of 2.6 percent - before the health reform in 2004, many couples quickly secured the higher reimbursement from the health insurances at the time.

No guarantee for "Baby take home"

However, the high rate of assisted births does not necessarily reflect the chances of success for individuals. In favorable cases (undisturbed ovarian function), the so-called "baby take-home" rate of reproductive medicine procedures is 27 percent. The success of the treatment depends heavily on the individual requirements, the cause of the infertility and the age of the partner.

A third of the couples go through more than one reproductive medical measure before the pregnancy succeeds. Women undergo hormone treatment most frequently (71 percent), followed by IVF or ICSI (41 percent) and insemination (29 percent).

Hormone therapy and insemination are comparatively seldom successful per attempt. The probability is around twice as high with IVF and ICSI - but the costs also increase.

Risks and Side Effects

Women in particular need to have a lot of time for fertility treatment. Daily visits to the doctor's office with very short lead times are not uncommon. Flexibility in terms of time at work is therefore a great advantage and helps to reduce part of the psychological stress.

Many couples go through an emotional roller coaster ride during the therapy cycles without any time pressure. If the egg cell is fertilized, a feeling of elation occurs, which is reversed if the embryo does not implant itself in the uterus. Almost every second woman shows signs of depression after unsuccessful treatment, according to a study by the Robert Koch Institute.

Physical problems are much less common. In a few women, overstimulation of the ovaries occurs as a result of the hormone administration. Gestational diabetes, high blood pressure, and caesarean sections are slightly more common. The biggest difference to natural birth is that multiple births occur more often, which in turn brings more complications. Reproductive medicine is therefore working hard to reduce the number of twins, triplets and quadruplets - and thus come even closer to nature as a role model.

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