Holistic Physical Therapy to Support Fertility Outcomes

Infertility has been an increasing topic of conversation on social media platforms as more people are opening up about

their own fertility struggles and the many treatments they have gone through. The increasing transparency of these infertility journeys may explain the growing population of women looking to further explore their fertility sooner rather than later. Although more information about infertility is being shared, it is unlikely that you’ve heard about the niche of physical therapy that can help optimize your fertility journey! Although no one can promise the outcome of a child, there are ways to increase your chances to be more likely to conceive.

In vitro fertilization (IVF) and intrauterine insemination (IUI) are the most commonly used terms surrounding infertility, but there is often less of a focus on the holistic practices that should be used in conjunction with those medical treatments. Treatment with a physical therapist who is trained in addressing infertility concerns would be a great adjunctive therapy to any medical intervention utilized. Additionally, this niche of physical therapy is also very helpful for those wanting to conceive without the use of medication as well. We believe in a multidisciplinary approach, meaning that we encourage working alongside other professionals to help improve fertility outcomes. This collaboration may be with a provider that is completing the IVF or IUI procedures, a functional medicine practitioner, a dietitian, a mental health therapist or any other healthcare professional you may be working with during this time.

Physical therapy for this specific population would use a hands-on approach with an emphasis on regulating the menstrual cycle and treating any fascial restrictions that may be hindering the ability for implantation. It is also going to have a large focus on decreasing stress and tension stored in the body to make for the best possible environment to conceive. The main goal of this specialized area of physical therapy is to promote overall wellness for improved fertility outcomes and address any restrictions or obstacles that may be impacting conception.

Infertility affects approximately 5 million women in the United States. ¹ Not only is infertility describing the difficulty of getting pregnant, but it is also about the difficulty of staying pregnant. ² Out of those 5 million women experiencing infertility, about 40% have mechanical infertility. Mechanical infertility is referring to dysfunctions of the musculoskeletal system as the reason for infertility, with pelvic adhesions as one of the primary causes. These pelvic adhesions may be due to trauma, infection, inflammation or surgery, and are a natural response to tissue damage. The interesting thing about pelvic adhesions is that they can still be present even after the damaged tissue has healed. Wherever the pelvic adhesions occur, they can cause a decrease in mobility and function, causing increased difficulty to conceive. ¹ Certain manual physical therapy techniques have been shown to improve these adhesions and restore mobility. ³

Common conditions where pelvic adhesions are present (this is not an all-inclusive list): ¹

Pelvic surgery
Endometriosis
Pelvic Inflammatory Disease
Tubal Obstruction
Polyps
Pelvic Spasms
Bowel Obstruction
Chronic Abdominopelvic Pain
Uterine Fibroids

Another primary cause of infertility is blocked fallopian tubes, with it being estimated to affect 25-35% of infertile women. ³ The standard of care for blocked fallopian tubes is currently surgery, however, as seen previously, surgery increases the likelihood of pelvic adhesions. When comparing the effectiveness in treatment between surgery and manual physical therapy techniques to open the fallopian tubes, it was shown that the manual techniques performed just as well or even better than the outcomes seen with surgery. Individuals that received the surgery prior to manual therapy did not have as much success than those who received just manual therapy treatment. The success rates of becoming pregnant after completing their plan of care, which included manual therapy techniques, were 68.9% for those who did not have a prior fallopian tube surgery, and only 34.5% for those that did have the surgery. ³

Endometriosis is another common cause of infertility. ³ Endometriosis is present in only about 11% of women, but has been seen to cause infertility in up to 68% of infertile women. Manual physical therapy techniques have also been seen to have similar or better results than with medication or surgery to improve a patient’s chances of conceiving. ³

The national average for pregnancy after IVF treatment in the United States as reported in 2010 was approximately 37.3%. ³ According to a study that was analyzing the effects of manual physical therapy techniques prior to undergoing IVF showed a pregnancy rate of 56.16%, which is 1.5 times higher than the national average for pregnancy after just IVF treatment alone. ³

The evidence supporting manual physical therapy techniques to decrease the physical barriers to conceiving is overwhelmingly positive. Not all causes of infertility are mechanical, but there are a large number of conditions that contribute to infertility that can benefit from manual treatment.

So, what do these manual techniques do to help with infertility? ²

Improve sexual dysfunction
Normalize pelvic alignment/function
Optimize nervous system function to address stress and anxiety
Increase scar mobility and decrease adhesions
Address any post-surgical dysfunction

We have seen significant improvements in adhesions and restrictions with the manual therapy techniques we use here in our clinic, and found these techniques to vastly help with pelvic dysfunction. If you or someone you know is struggling to conceive, manual therapy with a qualified provider may decrease adhesions to restore mobility and improve chances of conceiving. Call (330)528-0034 or visit our website to schedule your FREE 15-minute consultation with one of our pelvic floor fertility experts.

References:

Wurn, B. F., Wurn, L. J., King, C. R., Heuer, M. A., Roscow, A. S., Scharf, E. S., & Shuster, J. J. (2004). Treating female infertility and improving IVF pregnancy rates with a manual physical therapy technique. MedGenMed : Medscape general medicine, 6(2), 51.
Abraham, Yeni. "Rehabilitation Interventions to Support Fertility." Pelvicon, 9 Sept. 2023, Atlanta, GA.
Rice, A. D., Patterson, K., Wakefield, L. B., Reed, E. D., Breder, K. P., Wurn, B. F., King Iii, R., & Wurn, L. J. (2015). Ten-year Retrospective Study on the Efficacy of a Manual Physical Therapy to Treat Female Infertility. Alternative therapies in health and medicine, 21(3), 36–44.