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Treating Female Infertility and Improving IVF
Pregnancy Rates With a Manual Physical Therapy Technique*
Belinda F. Wurn, PT; Lawrence J. Wurn, LMT; C.
Richard King, MD; Marvin A. Heuer, MD; Amanda S. Roscow, MPT; Eugenia S.
Scharf, PhD; Jonathan J. Shuster, PhD
ABSTRACT
Objective: To assess the effectiveness of site-specific manual soft
tissue therapy in (1) facilitating natural fertility and (2) improving in
vitro fertilization (IVF) pregnancy rates in women with histories
indicating abdominopelvic adhesion formation.
Design and Intervention: Pursuant to 2 promising pilot studies, 53
infertile, premenopausal patients received a 10- to 20-hour series of
site-specific manual physical therapy treatments. Seventeen patients hoped
to achieve a natural pregnancy; 36 planned to undergo IVF within 15
months. The primary criteria for inclusion in the studies were the
inability to conceive following a minimum of 12 months of unprotected
intercourse and suspected or confirmed pelvic adhesions due to abdominal
and/or pelvic surgery, infectious or inflammatory disease (e.g.,
endometriosis, PID), or trauma. Treatments were specifically designed to
address biomechanical dysfunctions of the pelvis, sacrum, and coccyx and
restricted soft tissue and visceral mobility due to adhesions or
microadhesions affecting the reproductive organs and adjacent structures.
Main Outcome Measures: (1) Natural fertility group: pregnancy
within 1 year of therapy and subsequent full-term delivery; (2) Pre-IVF
group: pregnancy (via transfer of fresh embryos from nondonor eggs) within
15 months of the last manual treatment date.
Results:
Natural fertility group: Of the 14 patients available for follow-up (ages
25 to 44; mean, 33.5 years), 10 (71.4%) became pregnant within 1 year, and
9 (64.3%) reported full-term deliveries. Three of the 9 women who
delivered reported a subsequent pregnancy, suggesting that the treatment
protocol might have lasting effects. Two women have had a second live
birth delivery; and the third is still pregnant.
Pre-IVF group: Of the 25 patients available for follow-up (ages 28 to 44;
mean, 36 years), clinical pregnancies were documented in 22 of 33 embryo
transfers vs the US Centers for Disease Control and Prevention (CDC) 2001
age-adjusted expected number of 12.7 (P < .001). The estimated odds ratio
for a successful pregnancy in a cycle (manual treatment: no treatment) is
3.20 (95% confidence interval = 1.55–8.4).
Conclusions: The data trend across these studies suggests that this
innovative site-specific protocol of manual soft-tissue therapy
facilitates fertility in women with a wide array of adhesion-related
infertility and biomechanical reproductive organ dysfunction. The therapy,
designed to improve function by restoring visceral, osseous, and
soft-tissue mobility, is a nonsurgical, noninvasive manual technique with
no risks and few, if any, adverse side effects or complications. As such,
it should be considered a new adjunct to existing medical infertility
treatments.
*Wurn Technique®, patent pending |
