In the United States, about 13% of women aged 15-49 year old will experience infertility. Infertility is described as the inability to get pregnant after 12 months of unprotected intercourse. For those experiencing infertility, it can be a long, emotionally and financially taxing journey. Each woman’s journey is unique which can make it hard to navigate. 

There are many factors influencing infertility. Of the estimated 5 million U.S. women dealing with infertility, 2 million (40%) are affected by medical or hormonal infertility, 1 million (20%) have idiopathic fertility, and 2 million (40%) experience mechanical infertility. While medical and hormonal based infertility warrants attention of a medical doctor to address underlying imbalances, the category of mechanical infertility can benefit from physical therapy.

One of the primary causes of mechanical infertility is pelvic adhesions. These adhesions, or fibrous tissues, can form after surgery, inflammation, infection, trauma, or underlying conditions. Common conditions that can lead to formation of adhesions include endometriosis, poly cystic ovarian syndrome (PCOS), pelvic inflammatory disease (PID), fibroids, pelvic spasms, bowel obstructions, and chronic abdominopelvic pain. These adhesions can block the path of sperm and egg meeting and can decrease the mobility of organs in the abdominopelvic region, impeding their typical function. Decreased mobility of the organs and myofascia in the area can also decrease the blood flow and lymph drainage in the region.

As pelvic physical therapists, we are trained in identifying and evaluating abdominal and pelvic adhesion and are trained in manual therapy techniques to help break up and decrease these restrictions. We are also trained in visceral mobilization techniques to help organs and fascia move and glide as they should to improve their function and improve blood flow to those areas. Research studies have supported the use of targeted manual physical therapy techniques to improve fertility in women:

-In one study looking at manual therapy only as a treatment for infertility within specific dysfunction groups, found pregnancy rates to increase to 56.64% in those with occluded fallopian tubes, 42.81% in those with endometriosis, and 53.57% in those with PCOS. They also looked at a group that was concurrently undergoing in vitro fertilization (IVF) and found the addition of manual therapy to increase pregnancy percentages to 56.16%.

-Another study found targeted manual therapy techniques to effectively improve fertility in those determined to have mechanical infertility and not receiving additional treatment. This group had an improved pregnancy rate of 71%. This study also looked at a group undergoing IVF and also found concurrent manual therapy to improve IVF outcomes to about 66% pregnancy rate.   

-A third study followed 10 women who received 6 sessions of physical therapy with manual therapy techniques to release fascial restrictions, mobilize tight ligaments, and drain congested lymphatics. 6 of the 10 women conceived within 3 months of their last treatment. 

So yes, regarding mechanical infertility specifically, pelvic physical therapy has been shown to be an effective treatment for improving fertility naturally and for improving success of IVF treatment. Physical therapy is a non invasive and more cost effective treatment option than the classic infertility treatment journey. All women should consider physical therapy as a first line treatment option for infertility before attempting other options. Physical therapy is worth trying even in the first few months of difficulties getting pregnant. Why wait 12 frustrating months before seeking treatment? Women who have any predisposing factors to mechanical infertility–endometriosis, PCOS, PID, fibroids, chronic pelvic pain, or chronic GI issues–should seek pelvic physical therapy even before trying to get pregnant. Additionally, physical therapy should be a standard supplement treatment to every woman undergoing IVF. 

Schedule an appointment with a pelvic health physical therapist at MEND physical therapy in Boulder, CO to see if physical therapy can be an effective option in your fertility journey.

Rice AD, Patterson K, Wakefield LB, Reed ED, Breder KP, Wurn BF, King Iii R, Wurn LJ. Ten-year Retrospective Study on the Efficacy of a Manual Physical Therapy to Treat Female Infertility. Altern Ther Health Med. 2015 May-Jun;21(3):36-44. 

Wurn BF, Wurn LJ, King CR, et al. Treating female infertility and improving IVF pregnancy rates with a manual physical therapy technique. MedGenMed. 2004;6(2):51. Published 2004 Jun 18.

Kramp ME. Combined manual therapy techniques for the treatment of women with infertility: a case series. J Am Osteopath Assoc. 2012 Oct;112(10):680-4.