J. Vertebral Subluxation Res., December 8, 2003 1Pregnancy In A Previously Infertile Patient Following D.N.F.T. Chiropractic Care

CASE STUDY

Healthy Pregnancy In A Previously Infertile PatientFollowing D.N.F.T. Chiropractic Care: A Case Report

Jessica Shelley, DC

INTRODUCTIONInfertility, defined as the inability to become pregnant after

12 months of trying, affects approximately 6.1 million womenand men in the United States.1 Infertility affects men and womenwith almost equal frequency and infertile couples make up ap-proximately 10% of the reproductive age population in thiscountry. Approximately 20% of the couples who undergo de-tailed fertility testing are diagnosed with unexplained infertil-ity.2

About 9.3 million women have used infertility services atsome time during their lives. More than half of those seekingmedical treatment, including medication, insemination and invitro fertilization (IVF) are able to become pregnant. IVF, a

procedure in which a sperm and egg are combined in a labora-tory and the resulting embryo is transplanted into the uterus,accounts for less than 5% of all infertility services. IVF has asuccess rate of 22.8% live births per egg retrieval.3

Infertility is a widespread problem with vast social and eco-nomic effects. This article presents information on a naturalapproach to promoting and restoring health, which may in-clude reproductive function, by attending to nervous systemdysfunction through the application of chiropractic care.CASE REPORT

A 32-year-old female presented to the office on November3, 2001. She had never been pregnant, and with her husbandhad been trying to conceive a child for over two years with nosuccess. The couple had sought conventional medical treatment,including detailed fertility testing which indicated that the

ABSTRACTObjective: This case study describes the chiropractic care andprogress of a female patient with a history of infertility; exam-ining the relationship between D.N.F.T. specific care and thepatient’s clinical improvement and ultimate success in becom-ing pregnant.Clinical Features: A 32-year-old female with a history of in-fertility sought chiropractic care in November of 2001. Shehad attempted to become pregnant since August 1999, with nosuccess. She had received conventional medical treatment, in-cluding detailed fertility testing, artificial insemination, andtreatment with the fertility drug Clomid. On October 17, 2001,the patient underwent in vitro fertilization, which failed. Shesought chiropractic care three weeks later and an intitial evalu-ation was performed on November 3, 2001. The case historyrevealed additional complaints, including endometriosis, lowback pain, and frequent headaches. Surface EMG showed sig-nificant muscle asymmetry, with a marked elevation of muscletension on the left side in the area of L3.Chiropractic Assessment, Intervention and Outcomes:D.N.F.T. chiropractic analysis and correction were performedover the next six weeks and during this time, the patient’s sec-

ondary complaints of low back pain and headaches improveddramatically. A re-examination was performed on December28, 2001. Surface EMG showed a substantial improvement inmuscle symmetry, as well as a reduction in the muscle tensionpreviously noted at L3. The patient’s fertility specialists notedthat her estrogen levels, endometrial thickness, and cervicalmucus levels were all at more favorable levels than at the timeof the first in vitro attempt. A second attempt at in vitro fertili-zation was made on February 17, 2002, and the patient had apositive pregnancy test on March 2, 2002. She remained underchiropractic care and was in her 34th week of pregnancy at thetime of this writing.Conclusion: The human body is designed to be healthy and toreproduce. Impairment of this ability indicates dysfunction ona fundamental level. Subluxations of the spine and the associ-ated nervous system dysfunction can hinder proper functionof body systems. This study serves to document the applica-tion of chiropractic care and the subsequent response, includ-ing restoration of proper reproductive function, in a 32 yearold woman previously diagnosed as infertile.Key words: chiropractic, infertility, D.N.F.T., subluxation, preg-nancy, EMG

Jessica Shelley, DC, Private Practice, drshelley@earthlink.net,P.O. Box 181042, Cleveland Heights, OH 44118

J. Vertebral Subluxation Res., December 8, 2003 2Pregnancy In A Previously Infertile Patient Following D.N.F.T. Chiropractic Care

patient’s cervical mucus was sparse and thin. Testing indicatedthat her husband was not a contributing factor to their infertil-ity.

Over a two-year period, the couple tried many conventionaltherapies, including three attempts at artificial insemination andtreatment with the drug Clomid. None of these were success-ful, and eventually the couple decided to try in vitro fertiliza-tion (IVF). On October 17, 2001, the first IVF procedure wasperformed, but the procedure failed to result in pregnancy. Onthe advice of her cousin, a massage therapist, the patient de-cided to seek chiropractic care.

Case history revealed that the patient also suffered from en-dometriosis, low back pain, and frequent headaches. She hadbeen diagnosed with endometriosis at the age of 17, and suf-fered monthly pain and menstrual cramping. She also sufferedfrom migraine headaches that were worse during her periods.She complained of low back pain that was most bothersomewith her periods, but was also present when engaging in otheractivities such as lifting or walking her dog.

Surface EMG showed significant muscle asymmetry in thecervical and lumbar areas. Static Emg and Static Emg Asym-metry scans and data Table 1 demonstrated Pre-chiropracticcare findings are located on pages 3 and 4. There was signifi-cant elevation of muscle tension in the area of L3 on the left.Palpatory examination revealed tenderness and spasm at thelevels of C1, C2, and C3, as well as spasm throughout the lum-bar region with tenderness at the levels of L3, L5, and sacrum.The patient noted that she had discomfort in the area of theright sacroiliac joint when lying prone.

Directional Non-Force Technique (D.N.F.T.) chiropracticanalysis and correction were performed during nine visits overthe next six weeks. D.N.F.T. is a high-speed, low-force impulsetechnique. Both bony and soft tissue structures are addressed,including the vertebrae, ribs, discs, muscles and ligaments.D.N.F.T. chiropractic utilizes a challenge and “leg reflex” inlocating subluxations, and a light thumb thrust in deliveringadjustments. The leg reflex is a phenomenon in which one legpulls up short in response to the application of physical pres-sure to a subluxated structure. When physical pressure is ap-plied to an already irritated tissue, the body responds immedi-ately in a defensive manner, contracting all of the muscles onone side of the body. This is most clearly seen and easily mea-sured as a dynamic leg length deficiency.

By utilizing the leg reflex a chiropractor is able to determinewhich misalignments are actively causing nervous system in-terference, because only those misalignments will respond to aphysical challenge. These are considered primary subluxations.Frequently, the nervous system interference produced by a pri-mary subluxation will cause the body to compensate, produc-ing secondary subluxations. Secondary subluxations do notcause nervous system interference, but are one of the body’scompensatory mechanisms. It is the goal of a D.N.F.T. practi-tioner to adjust only primary subluxations, allowing compen-satory misalignments to resolve spontaneously once the pri-mary nerve disturbance is eliminated.

At the time of the first adjustment, the patient stated that shehad been suffering from a headache constantly for one week.Primary subluxations were found at C2, L3 and Sacrum. When

the patient returned the next day, she reported that her head-ache had resolved, that her middle and low back pain was greatlydiminished, and that she felt energized. She continued to notesubjective improvements over the next six weeks.

A re-examination was performed on December 28, 2001.Surface EMG showed a substantial improvement in musclesymmetry in both the cervical and lumbar areas. Muscle ten-sion in the L3 area was now within the normal range. StaticEmg and Static EMG Asymetry scans and data Table 2 dem-onstrating Post-chiropractic care findings are located on pages5 and 6. Palpatory examination revealed mild spasm withoutpain or tenderness at C1 and C2. There was mild tendernessnoted in the area of C7 bilaterally. In the lumbar area, mildspasm without pain or tenderness was noted at L5. The patientdid not complain of any discomfort when lying prone.

The patient remained under chiropractic care and was seenthree more times in January and February of 2002. In January2002, the patient also consulted an acupuncturist, whom shesaw four times during January and February of 2002. In earlyFebruary, she began preparing for a second attempt at IVF. Thepatient’s fertility specialists found that her endometrial thick-ness was greatly improved. Healthy eggs were found to be ingreater number and larger size than at the previous attempt.Eggs were retrieved on February 17, and two fertilized em-bryos were implanted on February 20. On March 2, 2002, thepatient had a positive pregnancy test. Ultrasound revealed asingle fetus. She has enjoyed an uncomplicated pregnancy andwas in her 34th week at the time of this writing.

DISCUSSIONInfertility is a widespread problem in the United States. Ap-

proximately 10% of the reproductive age population are affected,and 9.3 million have used infertility services at some point intheir lives. These services, which range from detailed fertilitytesting to drug therapy and microsurgery, are invasive and ex-pensive. One cycle of IVF cost an average of $7,800 in 1993.As the cost of both medical care and medical insurance premi-ums are rising rapidly, it is increasingly important to exploreother options.

One of the major premises of chiropractic philosophy is thatnormal nerve function is essential to good health. The spinalcord, which transmits nerve impulses between the brain andthe organs and tissues of the body, is supported and protectedby the spinal column. Vertebral misalignments, or subluxations,disturb normal nerve function.4 When nerve function is dis-turbed, dysfunction and dis-ease may result. Chiropractic ad-justments restore proper alignment to the vertebrae therebysupporting proper function to the nervous system. This pro-motes an increased state of health regardless of the presentingproblem or complaint.

Chiropractic care can affect reproductive health via severalmechanisms. Spinal movement contributes to the proper flowof cerebrospinal fluid (CSF).5 Restrictions of spinal movementalter the flow of cerebrospinal fluid and may impact the hypo-thalamus and/or pituitary gland. These glands are responsiblefor producing hormones such as follicle-stimulating hormone(FSH) and luteinizing hormone (LH) which are vital to repro-

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J. Vertebral Subluxation Res., December 8, 2003 3Pregnancy In A Previously Infertile Patient Following D.N.F.T. Chiropractic Care

Figure 1: Pre-chiropractic Care Static EMG Scan Normative Data

Figure 2: Pre-chiropractic Care Static EMG Scan Graphic

J. Vertebral Subluxation Res., December 8, 2003 4Pregnancy In A Previously Infertile Patient Following D.N.F.T. Chiropractic Care

Figure 3: (Top) Pre-chiropractic Care Static EMG Scan Asymmetry and data Table 1 (Bottom) Static EMG Scan Table

J. Vertebral Subluxation Res., December 8, 2003 5Pregnancy In A Previously Infertile Patient Following D.N.F.T. Chiropractic Care

Figure 4: Post-chiropractic Care Static EMG Scan Normative Data

Figure 5: Post-chiropractic Care Static EMG Scan Graphic

J. Vertebral Subluxation Res., December 8, 2003 6Pregnancy In A Previously Infertile Patient Following D.N.F.T. Chiropractic Care

Figure 6 (Top): Post-chiropractic Care Static EMG Scan Asymmetry and data Table 2 (Bottom) Static EMG Scan Table

J. Vertebral Subluxation Res., December 8, 2003 7Pregnancy In A Previously Infertile Patient Following D.N.F.T. Chiropractic Care

ductive functionn.6 Subluxations of the spine can also alter thefunction of any number of glands and organs that contribute toreproductive health.7 Though this case study addresses the im-plications for a female patient, male reproductive health can beaffected as well.

Although subluxations can be associated with pain or dis-comfort, in the majority of cases they are not. For this reason, itis helpful to use objective indicators such as surface EMG todetect imbalances and dysfunction in the nervous system. Inthis case, the patient’s subjective improvement correlated withimprovements in her EMG scans. At the same time, her bodywas showing signs of increased reproductive health, as mea-sured by her fertility specialists. Thus there appears to be a strongcorrelation between the decrease in clinical indicators of sub-luxation and the increase in the patient’s reproductive health.In many cases, further fertility treatment may not even be nec-essary.CONCLUSION

Subluxations of the spine can result in nervous system in-terference and dysfunction. This can lead to the decreased func-tion of an organ or system. In this case, the patient had clinicalindicators of subluxation in areas known to innervate the re-productive organs. As this patient’s subluxations corrected af-ter the application of chiropractic care, she advanced to ahealthier state, and was able to achieve and support a healthypregnancy.

The costs of medical care are skyrocketing. Medical inter-ventions for infertility are expensive, invasive, and frequently

uncomfortable (both physically and psychologically). Chiro-practic offers safe, affordable, non-invasive care. Any patientwith fertility or other health problems would benefit from in-creased nervous system function. Chiropractic care is an ap-propriate first choice for anyone seeking to increase his or herhealth potential, reproductive or otherwise.

Clearly, more research is needed to firmly establish the linkbetween subluxation correction and increased reproductivehealth. This case study serves to contribute to the growing bodyof evidence supporting this relationship. There is a great needfor further studies, including controlled clinical trials, that re-view and document the safety, efficacy and cost effectivenessof chiropractic care.REFERENCES1. Abma J, Chandra A, Mosher W et al. Fertility, family planning, and

women’s health: New data from the 1995 National Survey of FamilyGrowth. National Center for Health Statistics. Vital Health Stat 23 (19):7. 1997

2. Fact Sheet: In Vitro Fertilization. American Society for ReproductiveMedicine, 1998. URL: http://www.asrm.org/patients/factsheets/invitro/html

3. Patient’s Fact Sheet: Infertility. American Society for ReproductiveMedicine, 1997. URL: http://www.asrm.org/patients/factsheets/Infertility-Fact.pdf

4. Leach RA. The chiropractic theories: principles and clinical applications3rd edition. Baltimore, MD: Williams & Wilkins, 1994:121-197

5. Cramer GD, Darby SA. Basic and clinical anatomy of the spine, spinalcord and ANS. St. Louis, MO: Mosby-Year Book, Inc, 1995:57

6. Tortora GJ, Grabowski SR. Principles of anatomy and physiology 7thedition. New York: HarperCollins College Publishers, 1993: 530-531

7. Leach RA. The chiropractic theories: principles and clinical applications3rd edition. Baltimore, MD: Williams & Wilkins, 1994:168-172

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