When there is no physical explanation for childlessness, an emotional stress reaction is often seen as the background. Although there is no scientific proof of this, the mental and emotional stress experienced in very extreme situations can be so great that the body "refuses" to become pregnant.

In men the unfulfilled desire for a child and the futile waiting can also leave its mark. The pressure of being unable to father a child can also lead to self-doubt.
Discussing the emotional aspects of the situation is therefore a normal part of the medical consultation. A psychologist is also available at our clinic/practice to help you work through these issues.

The most common male fertility disorder is defective production of normally shaped (morphology) and mobile sperm (motility). There can be a number of reasons for this:

• A childhood mumps infection
  This can irrevocably destroy the sperm-producing cells in the testes.


• Varicose veins in the scrotum
  The heat of the varicose veins disrupts the process of spermatogenesis (sperm
  development). A temperature difference of only 0.7 °C can be crucial here.


• Undescended testicles
  Here it is the bodily warmth itself that disrupts spermatogenesis – it can even cause
  irreversible infertility.


• Hormonal Disorders
  Testosterone deficiency can result in reduced sperm counts or failure to produce
  sperm.


• Testicular trauma (e.g. falling from a bicycle) during childhood


• Diabetes


• Surgically removed tumours


• Stress


• Infections


• Environmental factors and lifestyle:
  Chemicals, pesticides, anabolic steroids and heavy consumption of caffeinated
  drinks can greatly impair the fertility of sperm.


• Heavy smoking and/or consumption of alcohol


• Blocked spermatic ducts

Unfortunately, it is often not possible to find a clear cause.

• Ovulation disorders
  This disorder can be caused by a hormonal irregularity in the ovaries or by an as yet
  unrecognised problem. Besides preventing ovulation, a hormonal imbalance can
  negatively influence egg cell maturation or the formation of the corpus luteum.


• Infertility due to problems with the fallopian tubes
  Fallopian tubes are the “conveyor belt” that take the sperm cells to the egg cell and the
  fertilised egg cells (embryos) toward the cavity of the uterus. If the fallopian tubes are
  partially or fully blocked it is harder or impossible for the sperm cells to reach the egg
  or the embryo to reach the uterus (risk of a tubal pregnancy).


• Blocked tubes can be caused by inflammations, previous tubal pregnancies, surgery or
  endometriosis (where tissue from the lining of the uterus forms and grows outside the
  uterus).


• Endometriosis
  Endometriosis is where tissue from the lining of the uterus forms and grows outside
  the uterus. Such growths can form in the urinary and gastrointestinal tracts as well as
  the abdominal cavity but can also affect the reproductive organs such as the fallopian
  tubes and ovaries, making it more difficult to conceive. The cause of endometriosis is
  still largely unknown.


• Problems with the uterus and cervix
  Like the neck of a bottle, the cervix is the narrowest point for the sperm on its way to
  the egg cell. Scarring (e.g. after surgery), blockages or inflammation in this area can
  also prevent reproduction. Fibroids or lumps of smooth muscle growth inside the
  uterus are sometimes the cause of sustained infertility or miscarriages.


• Malformations of the ovaries, fallopian tubes or uterus
  In very rare cases malformations –usually congenital – of the reproductive organs are
  the reason for involuntary childlessness.


• Polycystic Ovary Syndrome (PCOS)
  Infertility in women, especially those who wish to have a child, is often caused by the
  occurrence of many tiny cysts (sacs filled with liquid) in the ovaries (polycystic ovary
  syndrome). This disorder is usually associated with high levels of male hormones,
  obesity and a long and/or irregular menstrual cycle. As a result the woman’s hormonal
  balance is disrupted.


• Disorders of the immune system
  In rarer cases an immune response disorder is the cause of infertility in a woman. In
  women suffering from this dysfunction the immune system sees the egg cell or the
  sperm as a foreign body which it then attacks.