Infertility and repeated miscarriage clearly have many causes. Besides the better known reasons, such as blocked fallopian tubes, failure to ovulate, impotence and poor timing, the most likely causes have always been thought to be nutrition, toxicity, infection, hormonal imbalance, psychological factors and general debility.
So why would a chiropractor become interested in ways of helping in this field?
Although commonly associated with the correction of joint and muscular ailments, chiropractic evolved over 100 years ago on the theory that a particular type of joint manipulation influenced the nervous system, with the beneficial result of many improvements in health.
Not until the second half of the 20th century, however, were the non musculoskeletal benefits from chiropractic manipulation scientifically studied. The most recent research appears to confirm that as any responsible chiropractor today will tell you it does not cure organic disease. However, what is likely is that disorders of the spinal/pelvic joints mimic the symptoms of organic/visceral disease through common neuronal pools.
A number of papers have been published in well respected peer reviewed journals in which eminent cardiologists, neurologists, physiologists, chiropractors and physical therapists explain how spinal manual therapy has helped those patients who exhibited the symptoms of organic disease, if not the pathology usually associated with it.
Although my practice of 25 years has been mainly concerned with musculoskeletal problems, I have noticed that many of my treatments appear to sometimes help conditions such as asthma, poor circulation, heart rhythm disturbances and infertility.
The latter grabbed my attention early on in practice, particularly with a couple who had lost their third child in a tragic accident and wanted another child to complete their family. They had been trying without success for three years. The woman, who was 38, received one chiropractic treatment only and the husband two treatments a few months later. Within 12 months, they had a fine healthy child.
While interesting, this proved nothing. Since 1990, my new patient questionnaire has included questions for women of childbearing age concerning infertility, menstrual disorders and miscarriage. As a result, I discovered seven couples among them with fertility problems who came to me for treatment of other conditions. After treatment, only one of these couples failed to swiftly go on and have a child.
Then, in 1997, I attended a back pain convention in Prague. One of the speakers was Professor Karel Lewit, an eminent Czech neurologist and leader of the Manual Medicine Group in Eastern Europe. I was able to obtain a copy of the English translation of his noted book Manipulative Therapy in Rehabilitation of the Locomotor System (London and Boston: Butterworth-Heinemann Ltd, 1985).
Under the section on gynaecological disorders and low back pain, he stated: "There is growing evidence that female insterility with negative organic findings may be attributable to pelvic dysfunction."
He also quotes a randomised, controlled trial, conducted in 1992 by Volejn'kov and Krupicka, and later published in the West German journal Manuelle Medizin, which showed highly significant results.
In the study, 34 per cent of the women in the treatment group in the trial became pregnant within months, compared with 8 per cent in the 'sham' treatment groups. Treatment involved spinal and pelvic manipulation and massage plus stretching and relaxation exercises, while the 'sham' group were given a treatment which wasn't true chiropractic.
For ethical reasons, all women who did not become pregnant in the three groups not receiving the correct treatment the first time round were subsequently given the correct treatment. A further 27 per cent of these women became pregnant during the six months of the treatment regime.
All this information strongly suggests that there is a previously unconsidered factor in infertility. All 'handson' manual therapies have one thing in common they produce 'afferents', sensory nerve impulses which enter the central nervous system, with a resultant effect. Chiropractic treatments make for afferents from joint receptors and soft tissues. Nansel and Szlazak postulate that spinal afferents from dysfunctioning joints can produce results mimicking those of visceral afferents. It follows logically that correction of joint movements by specific manipulation could well remove the harmful afferents and, consequently, the apparent organic dysfunction (Journal of Manipulative Physiological Therapeutics, 18 (6): 379-97).
Volejn'kov and Krupicka have contributed to the growing evidence in recent years that female infertility with no apparent cause may be attributable to pelvic, spinal and rib dysfunction. Because it is the result of so many factors, there is no 'cure' for infertility. Medical screening and diagnosis may reveal an underlying cause. But, for the large majority of infertile couples whose condition remains a mystery, an appropriate spinal care regime might be a first
port of call before undertaking IVF, with all its attendant drawbacks.
!AMichael Davidson DC FCC