For many, the deepest wish of their life

What is unmet desire for children and how common is it?

An unmet desire for pregnancy affects many people who long for a child but, despite regular unprotected sexual intercourse over a period of one year, do not become pregnant. Doctors then speak of a fertility disorder, which can affect the woman, the man or both. The causes are diverse and often complex, so every couple needs an individual examination to clarify the specific reasons.

In Switzerland, around 10 to 15 percent of couples are affected by this issue, but there are numerous treatment options to increase the chances of giving birth.

What causes can lead to an unmet desire for children?

The causes of an unmet desire for children are varied and range from hormonal disorders to anatomical problems, often diagnosed with the help of reproductive medicine. Causes may be linked to either partner. In about 15 percent of cases the woman alone is affected, in 30 percent both partners and in 55 percent of cases the man – trends show an increase in male-related cases.

In both sexes, hormonal disorders, genetic conditions and infections can impair fertility. For example, polycystic ovary syndrome (PCOS) can disrupt the female hormonal balance and affect the cycle.

A malfunctioning thyroid can also throw the hormonal system off balance. In men, the most common cause is reduced sperm quality, which may be affected by environmental pollutants, illnesses or injuries such as orchitis.

Stress and psychological burdens affect the hormonal system and can be both a cause and a consequence of an unmet desire for children. If the wish for a child remains unfulfilled for a long time, it can lead to emotional strain and tensions in the relationship. These burdens worsen the problem, since mental well-being often directly impacts physical fertility.

Unhealthy lifestyle habits such as lack of exercise and an unbalanced diet can not only impair fertility but also influence family planning in the long term. Environmental pollutants as well as high alcohol or nicotine consumption deteriorate the quality of eggs and sperm. In men, pollutants and unhealthy lifestyles increase the risk of reduced fertility.

Desire to have children – how does pregnancy work?

When couples want a child, the path to pregnancy is often a process that requires patience. Many factors play a role, and pregnancy does not always occur immediately. About one third of all couples have to wait longer than a year to conceive. Sometimes the body simply needs time to adjust optimally for pregnancy.

Timing is crucial for pregnancy. The female cycle determines when fertilisation is possible. It is essential that a fertilising sperm cell meets a receptive egg – and that only happens during the fertile window. In a classic 28‑day cycle, ovulation occurs around days 14 to 16, and the fertile days are between days 9 and 18. During this period the probability of conception is highest.

The egg is fertile for only about 24 hours after ovulation, while sperm can survive up to five days in the woman's body. To get the timing right, intercourse about two days before to one day after ovulation is optimal. Some use methods such as cycle computers, ovulation tests or basal body temperature measurement to determine fertile days more precisely and improve their chances.

Desire to have children: is age or overweight more important?

Age and weight are central factors for both sexes but affect fertility in different ways.

Overweight can have significant hormonal and metabolic effects in both sexes, disrupting the natural reproductive process. Fat tissue is not only an energy store but also active in hormone production, releasing hormones such as oestrogen and immune‑active substances. In people with overweight, this hormonal balance often becomes disturbed, leading to fertility problems.

In women, a high body fat percentage can interfere with the hormonal sequence of ovulation and affect egg maturation. Increased production of male precursor hormones can further inhibit egg maturation. Insulin resistance – a common consequence of overweight – can lead to irregular cycles and reduce the likelihood of pregnancy.

Men are affected as well. Overweight can promote the conversion of testosterone to oestrogen, lowering testosterone levels and sperm quality. Sperm motility and count decrease, while testicular temperature rises and DNA changes in sperm may be promoted. Erectile dysfunction and comorbidities such as diabetes and high blood pressure, often associated with overweight, can further reduce birth rates.

Besides body weight, biological age also plays a role. Women are born with a limited number of oocytes; their quality and quantity decline with age. From age 30 fertility begins to decrease and after 35 the risk of complications during pregnancy rises. In men, sperm quality also declines with increasing age, although to a lesser extent.

What does endometriosis mean for the desire to have children?

Endometriosis can significantly affect the desire to have children because it impairs fertility on several levels. In this condition, cells similar to the uterine lining settle outside the uterus and cause benign growths called endometriotic lesions.

These lesions respond to hormonal changes during the cycle and can cause severe pain. The bigger problem for fertility, however, lies in the physical and biochemical effects on the body.

Endometriosis often leads to adhesions and scarring around the uterus and ovaries. These adhesions interfere with the natural fertilisation process, as the egg can no longer be transported or fertilised properly.

If endometriotic lesions are located in the fallopian tube or ovary, blockages can occur that mechanically prevent ovulation or fertilisation. The inflammatory processes triggered by endometriosis also disturb the biochemical balance, making ovulation, implantation and even sperm transport more difficult.

Endometriosis is one of the main causes of involuntary childlessness in women of reproductive age – up to 60 percent of those affected may be impacted. To improve fertility, surgical removal of the lesions is often recommended.

This increases the chances of a spontaneous pregnancy. If the disease recurs or fertility remains limited, assisted reproductive techniques can be an appropriate alternative and often offer better chances of success compared with further surgeries.

Treatment of endometriosis often complicates the desire for children further, because medication therapies to relieve symptoms can prevent pregnancy. Hormonal preparations that reduce endometriotic lesions often suppress ovulation, hampering conception. After stopping treatment, endometriosis often recurs.

Even when pregnancy is possible despite endometriosis, affected individuals should seek advice at a specialised endometriosis and fertility centre. The combination of modern techniques, scientific expertise and practical experience in treating endometriosis offers the best chances for a successful pregnancy.

What role does the psyche play in an unmet desire for children?

An unmet desire for children can be psychologically very burdensome and often affects the couple's whole life. The psyche plays a key role that can directly influence feelings and even bodily processes.

When couples desperately want a child and that wish remains unmet, a cycle of stress, anxiety and frustration often develops, which can negatively affect fertility. Psychological burdens such as stress influence the hormonal balance, reducing the chances of natural conception and also affecting the success rates of medical treatments.

An important aspect is the emotional exhaustion many couples experience. This shows up as feelings of grief, anger and hopelessness, especially after several failed attempts or miscarriages.

This ongoing psychological strain can lead partners to withdraw and isolate themselves from their social environment. Conversations or social situations that remind them of the unmet desire for children are often avoided. This increases the feeling of loneliness and isolation and further burdens mental health.

An unmet desire for children can also lead to tensions within the relationship. Many couples get into conflicts or feel misunderstood because they process the pain differently. Mutual support and open communication are particularly important at this stage, but are often difficult to maintain when both partners are struggling emotionally.

Active psychological support can be very helpful. Through counselling, peer support groups or therapeutic guidance, couples gain tools to better cope with the emotional challenges.

Therapies such as mindfulness training, yoga and meditation help to reduce internal stress and lay the foundation for positive thinking. These forms of self‑care can also strengthen mental balance and help approach the path to parenthood with greater calm.

Desire to have children: how to prepare your body optimally for the miracle of pregnancy

• Follow a balanced diet rich in folic acid, iron, zinc, vitamin D and omega‑3 fatty acids. These nutrients support fertility and create good conditions for a healthy pregnancy. Have your nutrient status checked by your doctor if needed.
• Smoking negatively affects fertility in both sexes. It interferes with the hormonal system and can reduce sperm quality. Quit smoking early so your body has time to recover.
• High stress can impair fertility. Practice relaxation techniques such as yoga, meditation or breathing exercises to calm body and mind and reduce stress.
• Keep your weight within a normal range. Both overweight and underweight can negatively affect fertility. A healthy body weight supports a stable hormonal balance and increases the chances of conception.
• Regular exercise promotes circulation and supports metabolism. Avoid excessive exercise, however, as it can disturb hormonal balance.
• Ensure sufficient sleep, because your body regenerates at night. Good sleep reduces stress hormones and helps maintain balanced hormone levels.
• In addition to a healthy lifestyle, reproductive medicine methods such as ovulation tracking or hormone therapies can improve fertility and facilitate the path to pregnancy.
• Use the symptothermal method. This method helps determine the fertile days of your cycle. Measure your basal body temperature daily and observe cervical mucus to increase your chances of becoming pregnant.
• Alcohol can restrict fertility and negatively affect the hormonal system. Avoid alcohol if possible or consume it in moderation.
• Many conventional lubricants can alter vaginal pH and hinder sperm motility. Use a lubricant that is conception‑friendly.
• Ovulation usually occurs mid‑cycle; the days just before and after are the most fertile. Use an ovulation test or cycle tracker to identify the ideal timing for intercourse.
• Discuss your desire to have children with your doctor early to identify and treat possible health obstacles.

The road to the desired child often requires patience, but with modern methods the chances are better than ever. Different routes and medical options can help couples increase their chances of starting a family. Openness to advice and information supports navigating this path in a positive and empowered way.