To have a child of their own is one of the deepest longings for many couples. But sometimes that bundle of joy takes a long time to arrive – as in the case of Saskia Weber*. Today she is 52 years old, her daughter Amélie* is eleven, and her son Luc* is five. For a long time, she thought that ever having two children was completely out of the question. “We hoped and worried for so many years, exhausted all medical options – and in the end, both our children came completely unexpectedly,” she says.

The ease or difficulty with which a woman gets pregnant depends on many factors. Lifestyle, hormonal processes, age – these all play a fundamental role in determining the chances of pregnancy. Studies by the World Health Organization show that about one in six couples has difficulty conceiving a child. Experts speak of infertility when pregnancy does not occur after 12 months of regular, unprotected sexual intercourse.

Saskia’s journey also began quite normally: she became pregnant for the first time at 33 – only to lose the child through a miscarriage. “It was a shock. We thought life was really starting – and suddenly it was all over.” Years passed without a second pregnancy.

Lifestyle, hormones, age – what influences fertility

Anyone who is thinking about having children soon comes to realise how many small things play a role. Smoking, alcohol, being overweight or underweight can significantly reduce fertility. Nicotine and obesity impair sperm quality in men, while a woman being extremely underweight can disrupt the cycle or stop ovulation altogether.

Regular exercise and a balanced diet, on the other hand, can help. A Mediterranean diet consisting of vegetables, fruit, whole grains, fish and healthy oils is considered particularly conducive to fertility. Doctors also recommend that women who want to have children take folic acid daily – ideally four weeks before possible fertilisation. This vitamin supports cell division and the development of the baby’s nervous system.

“At some point, I started to live more consciously: lots of exercise, no alcohol, only fresh food – I never smoked anyway,” recalls Saskia. “But at some point, it becomes a clinically scientific process, and you end up asking yourself: What am I doing wrong?”

When it just doesn’t work out

After three frustrating years, Saskia and her husband Marc* sought help at a fertility clinic. This marked the start of a phase full of tests and expectations. The doctors initially recommended insemination – introducing prepared sperm directly into the uterus.

The couple went through six cycles in vain. “It was incredibly exhausting,” says Saskia. “After every attempt, you cling to hope. And then at some point you just sit there and cry.” The subsequent diagnosis at least brought some certainty: Marc’s sperm quality was severely impaired. Natural conception seemed highly unlikely. The couple took the next step – in vitro fertilization (IVF).

Medical ways to have a child

Modern reproductive medicine offers a wide range of options today. Alongside hormonal stimulation to regulate the cycle or insemination, IVF is considered the most significant method. After hormone treatment, eggs are removed from the woman and fertilised in the laboratory with sperm. The fertilised eggs become embryos, which are then transferred to the uterus.

A further development is intracytoplasmic sperm injection (ICSI), in which a single sperm is injected directly into the egg cell – helpful in cases of very low or limited sperm quality. In Luxembourg, these procedures are also financially supported by the statutory health insurance (CNS) subject to certain conditions. These include the woman being under 43 years of age on the day of the last treatment, and neither she nor her partner having undergone voluntary sterilisation beforehand.

Hope, disappointment and saying goodbye

Saskia and Marc underwent four IVF cycles – without success. “There were moments when I no longer knew if I was still myself,” says Saskia. “You’re stuck in these treatment cycles, pumped full of hormones, and your life revolves around ultrasound appointments and lab results.” When the fourth attempt also failed, they decided to abandon their attempts. “I couldn’t take it anymore. We wanted to just live again, travel, laugh – just be normal.” At the age of 39, they gave up on their dream of having children. “We accepted that we would go through life as a couple and wanted to find new goals. It was sad, but also strangely liberating.”

Six months later, Saskia felt unusually tired. “I thought it was stress, maybe the flu. But even so, it just felt different.” The pregnancy test showed two lines. “I couldn’t believe it. Neither could Marc. And the doctor just said, ‘It’s a little miracle.’ ” Nine months later, Amélie was born – healthy, curious and full of life. “I was 40 and a first-time mother. It was the greatest happiness I could ever imagine.” The years passed and Saskia and Marc decided not to use contraception. “We thought: if it’s meant to happen again, then so be it.”

Six years passed without anything happening. At 46, Saskia noticed that her period had stopped. “I thought it was the start of menopause – but I was actually pregnant again.” And so Luc was born, a healthy boy who kept his parents on their toes once more.

Today, at 52, Saskia looks back on her story with humility. “I’ve learned that you can’t plan everything in life. Medicine can do amazing things – but sometimes you just need patience and a little luck.” Her story shows what numbers and diagnoses cannot capture: medical precision works wonders, but emotional strength, partnership and hope remain crucial.

A network of possibilities – and confidence

Luxembourg offers good facilities for couples who are unable to conceive to access medical assistance through the CNS statutory health service and specialised clinics. From optimising the hormonal cycle to insemination – IVF or ICSI – there are many ways to achieve the goal. Eggs or sperm can be frozen (cryopreservation) before cancer treatment, for example, or if family planning needs to be postponed for other reasons.

But despite all the technology, the desire to have children always remains a very personal, emotional journey. Saskia and Marc are living proof of this: between hope, despair, letting go – and the happiness that sometimes comes when you least expect it. As Saskia comments, “Sometimes life takes it upon itself to prescribe the perfect medicine.”

*Names changed by the editors