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Physical Therapy for Infertility

In 1995, the CDC's National Survey of Family Growth found that nearly 10% of the U.S. population considered of "reproductive age" is affected by infertility. According to the National Institutes of Health, 40% to 50% of infertility cases are caused by a factor affecting the woman including scarring, ovulation dysfunction, poor nutrition, hormone imbalance, ovarian cysts, pelvic infection, tumor or transport system abnormality from the cervix through the fallopian tubes.

Although physical therapy is not widely considered a treatment approach for women who are affected by infertility, one couple has been working to change that. Belinda Wurn, PT, and her husband Larry Wurn, a massage therapist, have developed an approach they have successfully used to treat women with infertility. The new therapy is giving hope to some of the most hopeless cases.

A Bit of History
In 1984, Belinda Wurn was diagnosed with cervical cancer. After surgery and radiation therapy, she developed "frozen pelvis" - a condition where the pelvic tissues adhere to one another. She was then informed at 33 years old that she was infertile and menopausal. In addition, she had significant chronic pelvic pain that kept her from working.

"I went to all kinds of specialists, and none of them really had any answers or were able to help me," she explained. "Larry and I started searching for alternative methods to address my pain. I traveled around the country and received different kinds of treatments. We took courses in several manual therapy techniques; gradually, we started refining the techniques we learned to develop our own techniques."

When Belinda was finally able to return to work in 1989, the Wurns decided to open a private practice clinic called Professional Touch Physical Therapy, or PTPT. The practice specialized in complicated chronic pain cases.

Their new practice was soon thriving and grew into several locations. Then PTPT was referred a workers' comp case: a woman with low back and pelvic pain. Prior to her therapy at PTPT, the woman had a history of ovarian cysts and multiple surgeries; she had been told she would not be able to have children because both of her fallopian tubes were blocked. When she started treatment at PTPT, the woman asked Belinda Wurn if it were possible to also work on her surgical scars.

During therapy, the woman announced to the Wurns that she was surprised to find out she was pregnant. "Apparently we broke up enough adhesions so that she was able to become pregnant and had a beautiful baby," said Belinda Wurn.

Subsequently, a physician friend who heard about the woman's situation referred another patient to the Wurns and then referred his own wife, who (after 12 years if infertility) had only one fallopian tube, and that tube was blocked.

"All of these women became pregnant and had children, so we went to the chief of staff at the local hospital and started conducting research on the phenomenon," explained Larry Wurn. "Several physicians and researchers encouraged us to create scientific data on our work. We hired a professional researcher from the National Institutes of Health and published several studies. Finally, we sold our five private practices to open Clear Passage Therapies."

A New Approach
The therapy has been effective for women with a history of endometriosis, blocked tubes, pelvic, coccyx or intercourse pain, cysts or PID and previous surgery or infection. Traditional medical techniques to treat these cases are surgical or pharmaceutical.

"There are 6 million infertile women in the U.S.," said Larry Wurn. "We are pleased to be able to offer a nonsurgical alternative for infertility treatment and to offer evidence-based science to back that up,"

According to Belinda Wurn, The Clear Passage Approach is a site-specific manual soft-tissue therapy that addresses adhesions and adhered tissues and structures of the female reproductive tract, the abdomen, the pelvis and throughout the body.

"We feel that we are breaking down cross-links in pelvic and reproductive structures. The cross-links are the building blocks of adhesions. These form as you heal from anything - surgery, trauma, infection or inflammation," explained Larry Wurn.

Screening is an important part of the process. Although there has been much success, not everyone is a candidate for the approach. "We screen everyone. There are contraindications to therapy, and we turn people down because we are working with very delicate tissues. We don't want to injure anyone," said Larry Wurn.

Some examples of contraindications are abnormal cysts, active infection and active cancer. Clear Passage maintains gynecologist advisors to help answer medical concerns.

The Clear Passage Approach has begun to pick up steam in the realm of infertility treatment. "A lot of our referrals come from word-of-mouth, and our Web site. Since we've had more than 150 babies born after [patients were] receiving our therapy, we've gotten quite a bit of coverage in consumer magazines and national television," explained Belinda Wurn.

Backed by Science
Since first developing this work, the Wurns have made efforts to further legitimate it through research and continued success. "We began hearing from more and more patients that they were getting pregnant when they had already tried medical techniques unsuccessfully," said Belinda Wurn.

The Wurns were first able to scientifically demonstrate their results by opening blocked fallopian tubes. While many of their clients were becoming pregnant, opening totally blocked fallopian tubes offered a more solid foundation for their claims. "You could tell if the tube opened by an independent diagnostic procedure," said Larry Wurn.

"If they hadn't had any other treatment than what we were doing, we could deduce that it was the work we did with them that made the difference," Belinda Wurn added.

The Wurns have published studies about their approach in the peer-reviewed journals Medscape General Medicine and Fertility and Sterility.1-5 "The [published] studies showed an increase in natural pregnancies, increase in IVF pregnancies, improved sexual function and significantly decreased intercourse pain," explained Larry Wurn.

Upcoming and ongoing research examines how the approach helps women with endometriosis pain and possible improvements in hormone levels.

The Next Crop
When it began, Clear Passage Therapies was a single location in Gainesville, Fla. Today, there are five Clear Passage clinics across the country, including clinics in Arizona, California, Iowa and New York.

The Wurns hope to expand, employing skilled manual therapists in other areas of the country. To do this, the Wurns have developed a training program specifically geared toward manual physical therapists. "We want to continue to grow both domestically and abroad. We will limit our growth within the bounds of finding great therapists. That's our main limiting factor - finding therapists we can train," said Larry Wurn.

He described this as an opportunity for therapists who want to break into a new market. "[The training program is] designed for PTs who would like to work in a setting where they're not rushed; they have 1 to 2 hours with every patient, every session," he said. "It's fun, exciting, getting great results and creating a new field of physical therapy. As a cash business, we work outside the realm of managed care, which creates a real business opportunity for PTs. People don't mind paying for getting that extra level of care."

"Patients are very compliant because they really want to be successful," added Belinda Wurn. "Some of the most significant aspects of our treatment are that we're achieving positive results without drugs or surgery in cases where previously surgery was really the only answer. And we're developing and publishing evidence-based science showing the effectiveness of a hands-on manual therapy for treating pain and dysfunction of various sorts. Previously, there were no known studies published for many of the conditions we treat with our hands."

Stefanie Carter is the former assistant editor at ADVANCE for Physical Therapists.

For more information about The Clear Passage Approach visit

1. Wurn BF, Wurn LJ, King CR, Heuer MA, Roscow AS, Scharf ES, Shuster JJ. Treating female infertility and improving IVF pregnancy rates with a manual physical therapy technique. Medscape General Medicine.2004:6(2):51. Available at: Accessed January 31, 2007.

2. Wurn BF, Wurn LJ, King CR, Roscow AS, Scharf ES, Shuster JJ. Increasing orgasm and decreasing dyspareunia (intercourse pain) by a manual physical therapy technique. Medscape General Medicine.2004:6(4):47. Available at: Accessed January 31, 2007.

3. Wurn LJ, Wurn BF, Kan M, King CR, Roscow AS, Scharf ES. Treating hydrosalpinx with a manual physical therapy. Fertil Steril. 2006; 86(3):S307.

4. Wurn LJ, Wurn BF, King CR, Roscow AS, Scharf ES, Shuster JJ. Treating endometriosis pain with a manual pelvic physical therapy. Fertil Steril. 2006; 86(3):S262.

5. Wurn LJ, Wurn BF, King CR, Roscow AS, Scharf ES, Shuster JJ. Improving sexual function in patients with endometriosis via a pelvic physical therapy. Fertil Steril. 2006; 86(3):S29-S30.


I am looking for a practitioner in the Kansas City area for my daughter.

Thank You,

Kathleen Kelley

Kathleen Kelley,  Registered NurseApril 20, 2011
Lee's Summit , MO


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