Treating fallopian tube occlusion with a manual pelvic physical therapy.

OBJECTIVE To determine the efficacy of a non-invasive, manual soft-tissue physical therapy in opening completely blocked fallopian tubes in infertile women with confirmed bilateral occlusion and a history indicative of abdominopelvic adhesions. DESIGN Retrospective analysis. SETTING Clear Passage Therapies, Inc, clinic, Gainesville, Florida. PATIENTS 28 infertile women (mean age = 35.2) with diagnosed complete tubal occlusion (proximal, midtubal, distal, or combination). The patients were being treated for various types of abdominopelvic pain and dysfunction (eg, intercourse and/or pelvic pain, menstrual cramps, endometriosis pain). INTERVENTION A 20-hour series of manual physical therapy treatments (mean duration = 1 week) designed to address pain and restricted soft tissue mobility due to adhesions and micro-adhesions. The therapists accessed some of the deeper structures (such as the fallopian tubes) indirectly by manipulating the peritoneum, uterine and ovarian ligaments, and neighboring structures. MAIN OUTCOME MEASURES (1) Unilateral or bilateral tubal patency confirmed by diagnostic test or natural intrauterine pregnancy; (2) natural intrauterine pregnancy rate achieved by patent patients within the 2-year follow-up period. RESULTS Of the 28 patients, 17 (61%, 95% exact CI 41%-78%) demonstrated post-treatment unilateral or bilateral patency, as measured by hysterosalpingography or natural intrauterine pregnancy. The median interval between the last treatment date and patency confirmation was 1 month. Nine of the 17 (53%) patent patients reported a subsequent natural intrauterine pregnancy. CONCLUSION Since truly occluded tubes are not known to reopen spontaneously, the results suggest this non-invasive therapy might be considered as an adjuvant to standard gynecological procedures in treating tubal occlusion.