Involuntary childlessness is when a pregnancy has not occurred after about a year without contraception. The reasons for this can lie with both partners.

The main possible causes for women are

• Blockage of the fallopian tubes (tubal occlusion)
• endometriosis
• Hormonal imbalances (e.g. PCOS)

Tubal occlusion as the cause of an unfulfilled desire to have children

Tubal occlusion is usually caused by an ascending infection of the vagina or by an infection of the fallopian tubes and ovaries (e.g. with chlamydia). This inflammation can lead to adhesions in the fallopian tubes, which restricts a woman's fertility.

Endometriosis as the cause of an unfulfilled desire to have children

Endometriosis is the lining of the uterus that colonises other parts of the abdomen and can cause pain during the menstrual cycle. It is not yet clear why a woman develops endometriosis. Although there is a familial cluster, just because the mother or sister has endometriosis does not mean that the desire to have children remains unfulfilled.

The main symptoms of endometriosis are pain during the period (dysmenorrhoea) or pain unrelated to the cycle. However, there may also be pain during sexual intercourse (dyspareunia), during bowel movements (dyschezia) or during urination (dysuria). However, it is also possible for those affected to have no symptoms. The special thing about endometriosis is that the extent, i.e. the degree of severity, in the body does not necessarily reflect the severity of the symptoms. Fertility can also be impaired in women with endometriosis, but not necessarily. Nevertheless, women with an unfulfilled desire to have children are more frequently affected by endometriosis.
Even if endometriosis is suspected on the basis of the anamnesis and ultrasound examination, endometriosis should be confirmed by a biopsy. For this, a laparoscopy is performed under anaesthetic. An initial preliminary consultation for a laparoscopy with the question of endometriosis can also be arranged via our UniFee.

Hormonal changes as the cause of an unfulfilled desire to have children

Hormonal changes are a common cause of infertility in women. An irregular, shortened or prolonged menstrual cycle or the complete absence of menstruation indicate an altered hormone level. The spectrum of possible hormone changes is broad and is determined in individual cases by measuring the hormone status over the course of the cycle. Polycystic ovary syndrome (PCO syndrome) is very common. PCO syndrome is a change in which the ovaries have many small follicles and the level of male hormones is often too high.