Beyond the Basics: How Pelvic Physical Therapy Can Boost Your Fertility Journey

Many know about the attributes of pelvic health physical therapy, helping with common issues that occur in pregnancy and postpartum, such as incontinence, pubic symphysis pain, or prolapse. However, not many people know how pelvic PT can help with fertility.

Infertility is an experience that affects about 13% of women aged 15-49 years old in the US, with many opting for assisted reproductive technology (ART) as the first option for conception. 

While many turn to modern interventions such as IVF or IUI for assisting with conception, there is an average of 7-18% who experience mechanical infertility. This type of infertility consists of abnormalities, congenital deformities, or scar tissue that disrupts the flow between the ovaries, uterus, and uterine tubes. 

In many cases where there is a deformity in the uterus, such as a uterine septum, there may be a need for ART to help ensure that the placement of the fertilized embryo is placed appropriately. In other instances, such as a blocked tube, caused by surgeries, endometriosis, tubal ligation, or ectopic pregnancies, the excess amount of fluid or scar tissue may decrease the opportunity for the egg being able to navigate its way from the ovaries through the tube and down into the uterus for fertilization.  

So, how can many of these instances be helped with pelvic physical therapy? 

The goal of pelvic physical therapy is to improve the mobility, increase circulation and support pelvic organs. Much of the work that I do as a pelvic PT is to ensure that the pelvic organs move well and are unobstructed from scar tissue, congestion from surrounding vessels or tight muscles and fascial tissue. 

Much of this work can be done internally, but given the sensitive nature of doing internal work, especially on those who may have experienced some level of pelvic trauma, working externally is a preferred option. While there are many methods to apply external work on the bladder, uterus, ovaries and uterine tubes, visceral mobilization is one that is a very gentle, specific, and targeted treatment that can help with improving mobility and increasing circulation to aid in conception. 

Another method that I have provided that has also been proven to be helpful and is externally based is Mercier Therapy (MT). MT follows a certain protocol that addresses many of the goals of pelvic PT, which encompasses the pelvic structures as well as the spine and abdomen. Many of the patients whom I have treated who have received both MT and/or visceral mobilization have greatly benefited in finding relief from the pelvic pain that can ensue with the restrictions that may occur with conditions like endometriosis. Although conception is not guaranteed, it does help set up a better environment for conception to either occur naturally or to set up a better chance for a successful IVF or IUI experience. 

Pelvic physical therapy can provide a great conservative treatment for those looking to address many of the conditions of mechanical infertility that may seem impossible to treat and provide more opportunities for the path toward conception. 

Key Takeaways to Consider:

1. Pelvic physical therapy isn't just for pregnancy-related issues—it can be a game-changer for those struggling with fertility.

2. For the approximately 13% of women experiencing infertility, pelvic PT offers a non-invasive alternative or complement to traditional fertility treatments.

3. Mechanical infertility (affecting 7-18% of cases) involves physical barriers to conception that pelvic PT can potentially address through specialized techniques.

4. The treatment focuses on:

   • Improving organ mobility

   • Increasing blood circulation to reproductive organs

   • Breaking down restrictive scar tissue

   • Creating a more favorable environment for conception

5. Two highlighted techniques—visceral mobilization and Mercier Therapy—are gentle, external approaches that can benefit those with previous pelvic trauma.

Why This Matters for WOVA Members

Pelvic PT represents an often overlooked approach to fertility challenges that aligns with WOVA's commitment to comprehensive women's health options. By sharing this information, we hope to expand awareness of all available pathways to conception, especially before turning exclusively to more invasive treatments.