Treating Endometriosis Infertility Without Surgery
Clear Passage is a world leader with over two decades of experience decreasing pain and improving fertility in women with endometriosis, without surgery or drugs. A large published study (Rice et al., 2015a) available in the U.S. Library of Medicine compared our pregnancy rates to those of surgery (see chart below). The study found conception rates for these women treated with our manual physio/physical therapy were comparable to the pregnancy rates with surgery and drugs, without the risks associated with those treatments. Complete the online Request Consultation form to receive a free phone consultation with a therapist to learn if we may be able to help you.
In another study (Rice et al., 2014), our success decreasing endometriosis pain was equivalent to surgical success, up to a year after completing therapy. This lasting effect is good news for many physicians and patients – who want to avoid the risks, costs and adhesions that tend to form after surgical intervention.
About EndometriosisIn endometriosis, the tissue that normally lines the uterus is found in other areas of the body. The most common areas are on and near the reproductive organs, binding these delicate tissue to other structures with adhesions.
This misplaced endometrial tissue responds to the menstrual cycle as it would in the uterus – endometriosis tissues swell during each monthly cycle. But unlike menstrual fluid that leaves the body every cycle, implanted endometriosis cannot exit the body. The inflammation that accompanies the swelling may cause additional adhesions or scar tissue to form at the site of endometrial implants.
How does endometriosis affect fertility?
Endometriosis is recognized as a primary cause of female infertility. In fact, 30-40% of women with endometriosis who are trying to conceive are diagnosed with infertility. (Bulletti et al., 2010) The Clear Passage Approach has been used by many women as an alternative to surgery for the pain and infertility associated with endometriosis. Its use is becoming more prevalent, due to the studies published on our work.Adhesions act like glue, binding reproductive structures in curtains or ropes of collagen, and sometimes attaching them to their neighbors. Bound as they are in adhesive straight-jackets, the reproductive organs cannot move or function normally.
Many theories exist to explain why endometriosis causes infertility. Some suspect that endometriosis is linked to an idiosyncrasy in a woman’s immune system that creates an autoimmune disorder, or makes the woman more likely to miscarry. Others believe irregular hormone levels in women with endometriosis contribute to infertility. (Gupta et al., 2008)
One cause that nearly all physicians can agree on is mechanical dysfunction. This occurs when endometriosis and the adhesions that so often accompany it attach to the delicate structures of the reproductive tract. Endometrial adhesions may attach to one or both ovaries, causing ovulation pain or decreasing their ability to release an egg. Adhesions can block fallopian tubes in two ways – squeezing them closed from the outside or blocking them from the inside.
We find that endometriosis located on or near the uterus can cause uterine spasm or painful periods, decreasing the opportunity for implantation, or causing miscarriage. Endometriosis which attaches to the nearby bowels may cause painful bowel movements, back or intestinal pain. In short, adhesions within the reproductive tract can cause pain anywhere in the back or pelvis, including intercourse pain – as well as infertility.
We know pelvic adhesions well. We faced this situation 20 years ago when the founder of Clear Passage, physical therapist Belinda Wurn, developed severe adhesions after surgery and massive radiation therapy to her pelvis. Unable to work due to the pain and having seen the devastating and debilitating effects of pelvic adhesions in her own patients, she was determined to find a non-surgical way to decrease pelvic adhesions.
Noting the common appearance of adhesions in their patients with endometriosis, physical therapist Belinda Wurn and her husband, massage therapist Larry, took a much deeper look at the etiology and biomechanics of adhesion formation. They found that the chemical bonds that attached each of the tiny collagen fibers to its neighbor to create adhesions appeared to dissipate when the Wurns used certain manual techniques on the adhesions. With this knowledge, they developed the Wurn Technique® to unravel the bonds between the cross-links that make up adhesions. At Clear Passage, we use their non-surgical “hands-on” approach to detach the adhesions that attach endometrial implants to various structures and tissues, with excellent results.
The “hands-on” work practiced at Clear Passage clinics is designed to reduce or eliminate adhesions, cross-link by cross-link. This works extremely well for women with endometriosis; many women who came to Clear Passage with a history of endometriosis and infertility are now mothers or currently expecting. Some have had several children after their five-day session at Clear Passage.
Numerous options and a significant amount of research are available to women who are diagnosed with endometriosis-related infertility. Scientific data allows consumers to compare the risks and success rates of various treatment options, including surgery, pharmaceuticals – and the Clear Passage Approach. The graph on this page compares our published success rates with the published success rates of other infertility treatments for women with endometriosis – giving a clear picture of the options and success rates.
In a 10-year study of 1392 infertile women (Rice, et al 2015a), the Wurn Technique / Clear Passage Approach rivaled or surpassed the standard for treating endometriosis-related infertility (surgery and pharmaceuticals), when 43% of our patients conceived after therapy. Many patients and their physicians are pleased to see that at its best, our non-surgical approach had results up to twice the pregnancy rate of endometriosis surgery.
Some women with endometriosis-related infertility also report moderate to debilitating pelvic pain. In 2011, a study in the Journal of Endometriosis titled “Decreasing dyspareunia and dysmenorrhea in women with endometriosis via a manual physical therapy” showed significant pain relief at all phases of the menstrual cycle and decrease in intercourse pain for women surgically diagnosed with endometriosis. (Wurn et al., 2011)
After receiving the Wurn Technique:
- 39% of participants reported decreased pre-menstrual pain
- 50% had less or no ovulation pain
- 61% had decreased menstrual pain, and
- 80% of participants reported decreased intercourse pain
In 2014, a follow-up report in the Journal of Endometriosis measured the long-term impact of the Wurn Technique on menstrual and intercourse pain in women with endometriosis. The results showed that our non-surgical therapy was equivalent to surgical results – twelve months after treatment, with 50% of patients reporting complete resolution of pain. (Rice, Patterson et al., 2014) This is great news for women with endometriosis who are facing surgery, but want to avoid the adhesions that so frequently follow surgical intervention.
Unfortunately, the surgery carries some risks, including:
1. risks associated with general anesthesia and infection;
2. surgical risks, such as inadvertent enterotomy – (mistakenly cutting the intestine or other structures);
3. the body tends to create adhesions to heal from the surgery designed to remove them.
These post-surgical adhesions can cause recurrence of pain or infertility;
endometriosis tends to re-grow and spread at and around surgical sites after surgery. A study published in Fertility and Sterility found that endometriosis was most likely to re-grow in the places where it was removed during laparoscopic surgery. The study also found that an unaffected region next to endometriosis was more likely to develop endometriosis after laparoscopic surgery. (Parker et al., 2005)
Pregnancy rates after laparoscopic surgery vary depending on the severity of endometriosis. Women with stage I-II endometriosis experience far greater success than women with stage III-IV. (Cirpan et al., 2013) This is because women with stage III-IV frequently have deep endometrial implants that a surgeon cannot remove without damaging the organ or tissue. In published research, Clear Passage pregnancy rates were shown to be equivalent to or double the surgical pregnancy rates, depending on the surgery performed. (Rice et al., 2015a)
Pregnancy rates after laparoscopic surgery also vary depending on the severity of endometriosis. Women with stage I-II endometriosis experience far greater success than women with stage III-IV. This is because women with stage III-IV frequently have deep endometrial implants that a surgeon cannot remove without damaging the organ or tissue.
Furthermore, a study published in Fertility and Sterility found that endometriosis was most likely to re-grow in the places where it was removed during laparoscopic surgery. The study also found that an unaffected region next to endometriosis was more likely to develop endometriosis after laparoscopic surgery.