Pu­blished: 9. Fe­bruary 2022 | Up­dated: 14. De­cember 2023 Author: Jo­hanna Kohnen | Re­viewed by Jo­hanna Kohnen

Psy­cho­lo­gical aspects of in­fer­ti­lity

But what is re­ally true about the con­nec­tion bet­ween fer­ti­lity and psy­cho­lo­gical fac­tors?

Psy­cho­lo­gical fac­tors: When the de­sire to have a child weighs on the soul

When the de­sire for a child (and, in the first step, for a pregnancy) is di­s­ap­pointed cycle after cycle, women and cou­ples are often ad­vised not to get too at­ta­ched to their child wish. “Relax, then it’s most li­kely to work out,” is ty­pical ad­vice. But what is re­ally true about the con­nec­tion bet­ween fer­ti­lity and psy­cho­lo­gical fac­tors?

Many cou­ples are hit by an unful­filled child wish quite un­ex­pec­tedly. For years for ex­ample, they have paid strict at­ten­tion to con­tracep­tion, con­cen­trated on fin­ding the right partner, worked on their careers or simply waited for the right time. When the hoped-for pregnancy doesn’t happen even after a long time, cou­ples often start to stumble. With each cycle and each new di­s­ap­point­ment, the de­sire to have children and the lon­ging for a pregnancy grow. Un­wanted child­less­ness is often per­ceived by cou­ples as a heavy psy­cho­lo­gical burden.

Often hurtful and un­hel­pful: the ad­vice to just “relax”.

It’s a vicious circle that re­peats itself every month: ovu­la­tion is cal­cu­lated, ever­y­thing is planned exactly, and yet the pe­riod still oc­curs. Many cou­ples are then ad­vised by those around them not to get bogged down in their de­sire to have children or to “just relax”. Ho­wever, the people gi­ving the ad­vice are often un­a­ware that these words and well-in­ten­tioned pieces of ad­vice can trigger com­ple­tely coun­ter­pro­duc­tive fee­lings. After all, many cou­ples have al­ready gone th­rough se­veral months (in some cases years) wi­t­hout using con­tracep­tion. Usually this be­gins wi­t­hout stress or thoughts that there might be dif­fi­cul­ties with one’s life plan. But at a cer­tain point, this ease tips over: cou­ples start to worry, put pres­sure on them­selves, and ques­tion their own bio­logy or even the part­ner­ship.

Often hurtful and unhelpful: the advice to just “relax”.

Do cou­ples with un­wanted child­less­ness have a dif­fe­rent psyche?

One often hears sto­ries that as soon as cou­ples di­stance them­selves from their de­sire to have children, or a first pregnancy has al­ready oc­curred and no fur­ther one is ac­tively planned, it sud­denly works out. Do cou­ples’ psy­cho­lo­gical fac­tors in­fluence their fer­ti­lity?

The ques­tion of whe­ther there is a pos­sible con­nec­tion bet­ween psy­cho­lo­gical fac­tors and fer­ti­lity or in­fer­ti­lity has been the sub­ject of va­rious sci­en­tific re­se­arch for quit some time.

The Hei­del­berg psy­cho­lo­gist, psy­cho­the­ra­pist and psy­cho­ana­lyst Dr. Tewes Wisch­mann, for ex­ample, in­ves­ti­gates this topic in his work [1]. Ho­wever, he de­scribes the simple view that psy­cho­lo­gical fac­tors and in­fer­ti­lity are di­rectly re­lated as in­suf­fi­cient [2]. Ac­cor­ding to cur­rent sci­en­tific know­ledge, cou­ples with an unful­filled child wish are, from a psy­cho­lo­gical point of view, in­iti­ally lar­gely un­re­mar­kable and psy­cho­lo­gi­cally si­milar to cou­ples wi­t­hout fer­ti­lity pro­blems [3].

The Bonn pro­fessor of gy­nae­co­lo­gical psy­cho­so­ma­tics, Dr. Anke Rohde, fur­ther em­pha­sises that in­fer­ti­lity pa­ti­ents with dif­fi­cul­ties in con­cei­ving are also not more neu­rotic per se than others, but re­pre­sent not­hing more than a “sec­tion of the normal po­pu­la­tion” — wi­t­hout any con­spi­cuous fea­tures as far as their per­so­na­lity, part­ner­ship or at­ti­tude to se­xua­lity is con­cerned [4].

The ef­fects of stress on hor­mone ba­lance

As it is so often the case, it is im­portant to di­stin­guish bet­ween causes and ef­fects. If in­fer­ti­lity pa­ti­ents suffer from stress and ten­sion (and are per­haps more de­pressed than their peers), this is in the first in­s­tance not the cause but often the con­se­quence of the unful­filled child wish. The psy­cho­lo­gical stress sur­roun­ding the unful­filled child wish can often be­come a life crisis for cou­ples, says Tewes Wisch­mann about the re­sults of the study “Hei­del­berger Kin­der­wunsch-Sprech­stunde” [5].

Ac­cor­ding to Tewes Wisch­mann, it is sci­en­ti­fi­cally proven that se­vere psy­cho­lo­gical stress can lead to si­gni­fi­cant hor­monal im­ba­lances in both women and men. This stress can come from very dif­fe­rent sources, for ex­ample from the pri­vate en­vi­ron­ment, or from the pres­sure that “it fi­nally has to work out with the child” and pos­sibly a re­lated part­ner­ship crisis. But other sources also play a role: a study from 2012 shows, that women who work more than 32 hours a week take si­gni­fi­cantly longer to con­ceive than women who work 16–32 hours a week [6]. And in men too, stress in work, so­cial life and per­sonal en­vi­ron­ment lead to lower sperm count, con­cen­tra­tion, moti­lity and even de­te­rio­rated mor­pho­logy [7].

psychological factors


Courtney Den­ning-Johnson Lynch from Ohio State Uni­ver­sity in Co­lumbus proves in her study that a high stress factor can make con­cep­tion more dif­fi­cult or even pre­vent it. Ac­cor­ding to the re­sults, a high con­cen­tra­tion of stress hor­mones in the blood en­sures up to 30% re­duced chance of con­cep­tion [8]. In evo­lu­tio­nary bio­logy, this can be at­tri­buted to the fact that in ear­lier times it was po­ten­ti­ally sen­sible not to con­ceive children du­ring stressful and tur­bu­lent times.

Even though life si­tua­tions (and as­so­ciated st­res­sors) are highly in­di­vi­dual: The more you ma­nage to re­duce stress, the more your hor­mone ba­lance will be fa­vourable when you want to have children, which in turn makes pregnancy more li­kely to occur [9].

Fur­ther­more, cou­ples who want to have children should first and fo­re­most mo­de­rate their ex­pec­ta­tions and pres­sure to per­form. Do what is good for you! Go out, con­cen­trate on the po­si­tive things in life. Do sports for ba­lance and sleep tog­e­ther as often as you want — not only du­ring the fer­tile days. Be­cause fre­quent se­xual in­ter­course pro­motes con­cep­tion, as a study by the In­diana Uni­ver­sity of Bloo­mington proves. Women who have sex often in­fluence their im­mune system, which helps the sperm to over­come the wo­man’s im­mune de­fences and fer­ti­lise an egg [10].

About Fer­tilly

At Fer­tilly, we have made it our mis­sion to ac­com­pany cou­ples (ho­mo­se­xual and he­te­ro­se­xual) and sin­gles on the way to ful­fil­ling their child wish. In doing so, it is im­portant to us to create trans­pa­rency in the area of fer­ti­lity ser­vices, to pro­vide in­for­ma­tion and know­ledge on the to­pics of pregnancy and fer­ti­lity and to help you to find the most sui­table Fer­ti­lity Center. Th­rough co­ope­ra­tion with first-class Fer­ti­lity Cen­tres and cli­nics in Eu­rope, en­qui­ries about Fer­tilly are given pre­fe­ren­tial tre­at­ment. This means that our pa­ti­ents avoid the usually long wai­ting times and get ap­point­ments more quickly.

If you would like more in­for­ma­tion about Fer­ti­lity Cen­ters, suc­cess rates and prices, please contact us using this ques­ti­on­n­aire. We will ad­vise you free of charge and wi­t­hout any ob­li­ga­tion.

  • Answer the first ques­tions in the on­line form in order to book an ap­point­ment. This way we can better ad­dress your needs du­ring the con­ver­sa­tion.

  • We will find the best contact person for your in­di­vi­dual needs. Sche­dule 20 mi­nutes for the con­sul­ta­tion.

  • We will in­tro­duce you to the right fer­ti­lity clinic from our net­work, make an ap­point­ment and ac­com­pany you until your wish for a child is ful­filled.

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1. Stammer, H., Wisch­mann, T., Verres, R. (2004): Paar­be­ra­tung und — the­rapie bei un­er­fülltem Kin­der­wunsch. Hog­refe, Göt­tingen.
2. Wisch­mann, T., Stammer, H. (2010): Der Traum vom ei­genen Kind. Psy­cho­lo­gi­sche Hilfen bei un­er­fülltem Kin­der­wunsch. Kohl­hammer, Stutt­gart.
3. Ken­te­nich, H., Wisch­mann, T., Stöbel-Richter, Y. (2013): Fer­ti­li­täts­stö­rungen — Psy­cho­so­ma­tisch ori­en­tierte Dia­gnostik und The­rapie. Leit­linie und Quel­len­text — 1.Revision. Psy­cho­so­zial Verlag, Göt­tingen.
4. Rohde (2001). Zur psy­chi­schen Si­tua­tion un­ge­wollt kin­der­loser Paare. In W. Ft­he­n­atkis & M. Textor (Hrsg.), On­line-Fa­mi­li­en­hand­buch. Mün­chen: Staats­in­stitut für Früh­päd­agogik.
5. Wisch­mann T., (1998): Hei­del­berger Kin­der­wunsch-Sprech­stunde. Eine Studie zu psy­cho­so­zialen Aspekten un­ge­wollter Kin­der­lo­sig­keit. Verlag Peter Lang, Frankfurt/Main.
6. Mut­s­aerts MA, Groen H, Hui­ting HG, Ku­chen­be­cker WK, Sauer PJ, Land JA, Stolk RP, Hoek A. The in­fluence of ma­te­rnal and pa­ternal fac­tors on time to pregnancy–a dutch po­pu­la­tion-based birth-co­hort study: the GECKO drenthe study. Hum Re­prod. 2012;27:583–593. doi: 10.1093/humrep/der429.
7. Li Y, Lin H, Li Y, Cao J. As­so­cia­tion bet­ween socio-psycho-be­ha­vi­oral fac­tors and male semen qua­lity: Sys­te­matic re­view and meta-ana­lyses. Fertil Steril. 2011;95:116–123. doi: 10.1016/j.fertnstert.2010.06.031.
8. Lynch, C.D., Sun­daram, R., Maisog, J.M., Sweenez, A.M., Buck Louis, G.M. (2014): Pre­con­cep­tion stress in­creases the risk of in­fer­ti­lity: Re­sults from a couple-based pro­s­pec­tive co­hort study-the LIFE study. Human Re­pro­duc­tion, Vol.29, No.5 pp. 1067– 1075, 2014.
9. In­stitut für De­mo­skopie Al­lens­bach (2007): Al­lens­ba­cher Be­richt 11/2007 Un­frei­wil­lige Kin­der­lo­sig­keit Pook, M./Tuschen-Caffier B./Krause et al. (2000): Psy­chi­sche Ge­sund­heit und Part­ner­schafts­qua­lität idio­pa­thi­scher in­fer­tiler Paare. In: Brähler, E./Felder, H./Strauß, B. (Hrsg.): Frucht­bar­keits­stö­rungen. Jahr­buch der Me­di­zi­ni­schen Psy­cho­logie 17: 262–271.
10. Lo­renz TK, Heiman JR, Demas GE. In­ter­ac­tion of mens­trual cycle phase and se­xual ac­ti­vity pre­dicts mu­cosal and sys­temic hu­moral im­mu­nity in he­althy women. Phy­siol Behav. 2015;152(Part A):92–98.