How Physiotherapy Helps Women Undergoing Assisted Fertility Treatment

How Physiotherapy Helps Women Undergoing Assisted Fertility Treatment

Over the past two years, our clinic has seen a significant rise in the number of women using assisted reproductive technology to help grow their families. Our renowned women’s health physiotherapist, Mandy Tik, estimates that 60% of the pregnant women she works with have undergone either intrauterine insemination (IUI) or in vitro fertilisation (IVF).

This incredible and life-changing technology is creating a world of possibilities for women that have struggled to fall pregnant naturally, either due to known medical issues or unexplained infertility. Age is also a big factor, with significant declines in the ability to naturally conceive after the age of 35 years being well documented. Thanks to reproductive technology, however, in February 2022, over 80% of expecting mothers under Mandy’s prenatal physiotherapy care were over the age of 41, with one mother aged 49 years - and in the same month, Mandy had the joy of meeting ten healthy new deliveries.

With the brilliant potential that assisted reproduction unlocks, there are a few common patterns that Mandy has noticed during her 20+ years of experience. Specifically, two of these are related to women with polycystic ovary syndrome (PCOS), and those using the fertility drug, Clomid. Here’s how both circumstances are affecting women, and how Mandy is using her specialised knowledge to help relieve the associated discomfort in women that are trying to conceive while supporting expectant mothers towards smooth and healthy deliveries.

Polycystic Ovary Syndrome

PCOS affects between 4% and 20% of women of childbearing age worldwide. It can lead to numerous stressful symptoms as a result of the hormone irregularities that stop the release of eggs from the ovaries, but that doesn’t stop them from being produced, which leaves the ovaries enlarged and containing many follicles.

One common symptom of PCOS is irregular, lengthy or painful menstrual cycles. Over time, this can lead to the muscles and tissues in the lower abdomen being in an ongoing state of stress, tension and guarding. Mandy helps these women by using manual therapy to relieve the tension in the muscles in the lower abdomen while providing very specific pain relief exercises.

Another symptom of PCOS is weight gain around the abdominal region. From Mandy’s dedicated work, she noticed that under these circumstances, her clients could struggle with finding and engaging their core, which was preventing them from performing the necessary exercises to best support their bodies not just through the symptoms of PCOS, but for conception, pregnancy, and childbirth. This is where Mandy helps by applying her unique sonography technique that she has developed over the past ten years, helping her clients locate their core muscles and effectively teaching them how to activate the muscles and what engaging them feels like - something that can otherwise be confusing when relying on sensation alone.


Clomid (clomiphene) is a common drug that is greatly supporting women during their fertility journey with a 6-month live birth rate of between 20% to 40%. It works to induce ovulation by stimulating women to grow and release an egg under circumstances where they may not ovulate on their own, including PCOS. One common side effect of taking Clomid is weight gain, particularly around the midsection, which Mandy notices in most of her clients that have gone through more than two cycles of Clomid. To help support these women through their pregnancies, Mandy creates a specialised program that focuses on toning and safe strengthening of their core from the first day that they are cleared by their OBGYN to have physiotherapy care.

Delivering Expert Physiotherapy Care For Fertility & Pregnancy Around The World

While the COVID-19 pandemic has disrupted many fertility services and added much stress to couples trying to conceive or those needing to access health services through their pregnancy, Mandy has continued to use her 20+ years of experience to deliver her services both in-person and extensively via telehealth since March 2020, working with clients across Russia, Turkey, Singapore, Thailand, Canada and the UK.

Mandy is well known for her work with clients undergoing fertility treatments, and stays in communication with their referring doctors and fertility specialists, continuing to advocate for her clients and helping them find the best balance between rest and exercise. She also runs customised pre and post-natal programs with her clients' safety as a priority. These focus on helping her clients find the right way to move for their bodies and unique circumstances, which is often very different to the generalised pregnancy exercise guidelines available online. Mandy also works extensively with clients that have abdominal muscle separation from pregnancy (diastasis recti), urinary leakage and back pain.

Mandy’s message to women is that they continue to give so much and take on so much stress and responsibility, acting as a ‘stabiliser’ in the family - and so they shouldn’t ignore getting the help they need.