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by Lisa B. Samalonis

The struggle that thousands of couples face with conception and infertility can become a nagging see-saw of hope and renewed monthly heartbreak, invisible to the naked eye yet latent, inexorable, hiding just below the surface of a person’s public persona.

Because many find the subject too personal or painful to discuss in public, couples in this situation ally themselves with the tools, and the probing, invasive tests that the worlds of medicine, counseling, and psychology have to offer.

Yet when infertility is linked to a history of abdominal or pelvic infections (such as pelvic inflammatory disease (PID), bladder or yeast infections, and endometriosis), single or repeated surgery (such as laparoscopy, C-section, or back surgery), a fall, trauma, abuse, or radiation therapy, and when one or a combination of those factors have caused adhesion formation, a simple but revolutionary solution may have been overlooked.

Recent studies show that an individualized, manual (hands-on) form of physical therapy, also known as site-specific massage to the body’s soft tissues, may help infertile women conceive.

“The primary goal of our therapy is to increase mobility and decrease pain by using specific techniques to break down the excess collagenous cross-links which are at the core of adhesion formation,” explains Larry Wurn, LMT, a massage therapist and the clinical co-director of the Gainesville, Florida-based Clear Passage Therapies (a group of small, private clinics). “These excess cross-links may cause pain and limited movement. It would be very difficult for us to break down the primary adhesions which allowed the patient to heal. However, we have strong clinical evidence that we can greatly decrease the excess cross-links which appear to be the cause of so much pain and dysfunction.”

Wurn developed the technique to help his physical therapist wife, Belinda Wurn, after she experienced pain following several surgeries and pelvic radiation.

“The Clear Passage philosophy addresses the entire body. The therapists use their hands to gently adjust, apply traction, mobilize, massage, and stimulate the structures of the body from head to toe, in order to restore balance and symmetry,” he says.

Clearing Passages

After injury, infection, or surgery, patients may experience pain, dysfunction, or increased tissue tension in their body. Symptoms may appear in muscles, joints, connective tissues, and organs. According to Wurn, problems can occur in the body due to the adhesions formed following the original trauma. Pain and dysfunction can also occur months or years later, due to the body’s compensations in response to the injury, surgery, or infection.

Adhesion formation occurs after trauma to the tissues, as a response to the tissue damage. After an injury, infection, or surgery, tiny yet strong collagen fibers form as part of the body’s response to the trauma. These collagen fibers form adhesions by laying down “cross-links” in random patterns, which form the building blocks of scar tissue. “Adhesions can be tough and wiry, or filmy and thin,” says Wurn. “They may be large enough to be seen by diagnostic tests, or so small that they are microscopic. Either way, they can exert tremendous tensile forces on the tissues where they form.”

Adhesions and cross-links may remain in the body long after the original inflammation or trauma has healed. “They may adhere the injured tissues to nerves (causing pain) or to neighboring structures (causing dysfunction),” Wurn explains. “As the body’s tissues heal and adhesions are formed, the tissues begin to shrink somewhat, resulting in decreased movement in the injured area. Thus, the healing process can actually create more mechanical irritation and more cross-linking of collagen fibers, perpetuating the cycle of adhesion formation.”

The treatment focuses on the adhesions in the soft tissues, such as muscles, organs, and connective tissues. The latter may become shorter, restricted, or adhere to neighboring structures after surgery, injury, infection, or inflammation.

Wurn points out that when adhesions or tiny micro-adhesions form around and between structures (including the reproductive organs), the organs may, in turn, adhere to other structures. This restricts the organs, causing them to potentially become painful and/or lose their ability to function properly.

Pain complaints may include back, hip, or neck pain; headaches at the base or top of the skull or temples; cramping, painful menstruation, or pain with intercourse. Functional problems include constipation, loose bowels, poor digestion, or infertility.

Adhesions may cause blocked fallopian tubes, poor function of the fimbria, ovaries restricted by thick or filmy adhesions or deviation of the cervix, making a difficult passage for sperm. “A sheet of filmy adhesions may decrease the uterine wall’s ability to allow implantation, causing a miscarriage after fertilization. Ovarian adhesions may cause decreased hormonal function,” Wurn says.

How Wurn Technique Is Done

The therapist applies a gentle, specific stretch with the hands for a sustained period of time to tightened areas in the body’s connective tissues until the tension releases.

According to Wurn, this release of tension suggests a breakdown of the cross-links, which have been adhering structures. The release allows those structures to move more freely, generally with decreased pain. “The result is improved mobility of the soft tissues, which the patient notices as decreased pain and increased function.”

Wurn defines candidates as women with a history of abdominal or pelvic infection (such as PID, bladder or yeast infection, or endometriosis), those who have undergone one or more surgeries (such as laparoscopy, C-section, or back surgery), or a fall, trauma, abuse, or radiation therapy. This treatment is not recommended for women with an active infection, cancer, hemophilia, HIV, or those whose fallopian tubes have been closed surgically and never re-opened. It is also not recommended for male factor infertility.

Early Results

He notes that the initial results have been very promising, and they are conducting clinical studies in the areas of site-specific massage´s effect on infertility reversal; opening blocked fallopian tubes; increased sexual function; decreased pain with menstruation, ovulation, and intercourse; decreased FSH levels; and increased pregnancy and birth rates with therapy administered prior to IVF transfer.

“We performed two pilot studies before we began a more intensive scientific investigation. Fifty percent of the infertile women in the pilot studies had full-term pregnancies, and an additional 25 percent had at least one fallopian tube clear after treatment.” Wurn says that this nonsurgical treatment apparently improved reproductive capabilities in 75 percent of the women, without drugs or surgery. “Subsequent studies with many more patients appear to validate these results,” he adds. “These rates compare favorably with many medical techniques, but at a lower cost and without the risks of surgery or drugs.”

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