In Switzerland, about one in six couples cannot have children. And although the issue is so wide-spread, it often leads to a great deal of stress for the affected couples. The physicians working at alta uro are very much aware of this situation and offer compassionate advice, diagnostics, and therapy to treat involuntary childlessness.

What are the possible causes of involuntary childlessness?

The World Health Organization WHO defines an unfulfilled desire to have children or involuntary childlessness as a failure to achieve pregnancy over a period of one year in spite of regular and unprotected sexual intercourse. According to current studies, the causes are found in app. 20-30% of the cases in men and in about 20-30% of the cases in women, plus in about 25-40% of the cases in both partners. Fertility disorders in women are primarily diagnosed by a gynaecologist and include:

  • disorder of egg maturation,
  • disorder of egg transport in the fallopian tube and
  • disorders of the uterine function.

Possible causes of involuntary childlessness include:

  • disorders of sperm-cell formation,
  • disorders of sperm transport (motility),
  • disorders of ejaculation.

Possible causes of fertility problems in both men and women include inflammations or psychological causes such as pronounced stress. In approx. 10-20% of the couples, even modern diagnostics can find no obvious cause of the unfulfilled desire for children.

What test are carried out on men with an unfulfilled desire to have children?

The first step is a detailed medical consultation to assess the situation regarding the involuntary childlessness. The consultation helps clarify possible causes, such as previous or current illnesses, hereditary diseases in the family, previous illnesses, or the taking of specific medication. Besides, lifestyle behaviour such as smoking, alcohol consumption, sports activities, or the frequency of sexual intercourse will be assessed.

The physical examination will include, besides a general examination, a specific one of the sexual organs, in order to detect, e.g., any changes in the testicles. An ultrasound scan will be carried out, too.

Additional laboratory tests will follow, including a blood test for the hormone status and an analysis of the seminal fluid and sperm cells, a so-called spermiogram. The spermiogram will thereupon be compiled by a specialized laboratory and provides information on the quality of both the seminal fluid and the sperm cells.

What treatments and therapies are possible for involuntary childlessness?

The treatment depends on the cause of the involuntary childlessness. As the quality of sperm cells and the seminal fluid are subject to certain fluctuations, any harmful substances and damaging behaviour should be refrained from. This includes, e.g., abstaining from nicotine, reducing alcohol consumption, abstaining from excessive sports activities and avoiding other intoxicating substances such as cannabis. These measures often lead to a substantial improvement of the quality of the spermiogram and a successful pregnancy. If there should be an infection caused by bacteria, an antibiotics therapy is recommended.

The effectiveness of so-called antioxidants on sperm quality is discussed controversially, however it may well be a worthwhile approach in individual cases. If there is a varicose vein in the area of the testicles, its surgical removal may be indicated. If, however, no cause can be found that can be treated with the aforementioned measures, it is advisable to present the case to a centre of reproductive medicine for assisted/artificial insemination. Alta uro closely works with centres of reproductive medicine and, in the context of an artificial insemination, also carries out biopsies of testicular tissue to harvest sperms (so-called testicular sperm extraction or TESE).