Time passes and nothing. No sign of any storks. No indication that anything has changed in the womb. Even though the experts say that male and female infertility are on a par as regards the inability of couples to have children (40% in each case), and that a combination of the two is responsible for 20% of these cases, let‘s give priority to female curiosity in how spa balneology can help them carry out one of their natural functions – i.e. contribute to reproduction of the species.

According to a study carried out by Professor Collins from Ontario University in 2005, there are about 90 million couples in this world that have problems having children. About 94% of them, however, do not seek medical help. That means only about 6% of them turn to a specialist for help. In addition to other progressive methods, specialists can recommend a course in gynaecological balneotherapy, which not only helps in treating female infertility in its early stages, but also in those cases where all the most modern methods have failed.

What is infertility?

“In medicine infertility is when a couple has not conceived after contraceptive-free sexual intercourse over a period of one year,” says Dr. Jaroslav Kozma, a spa doctor specialising in gynaecology in Františkovy Lázně. This is when the first specialists come in to try to diagnose the reason for infertility. However, he says beforehand that infertility does not automatically mean that one of the partners is ill in any way. “In the case of one form of immunological dissonance both partners are quite healthy and could have children with someone else. We see a married couple as being one, and so in this sense we regard infertility as being an illness.”

When infertility continues year after year and the alarm clock starts ringing, gynaecologists turn to other medical branches for help, and those include balneology. “This is in the event that infertility is for hormonal reasons, when the womb is not completely developed, when the ovarian tubes are blocked, in conditions following operations where the internal reproductive organs could have been affected, but also in cases where the reasons are not known, when there could be disruptive psychogenic factors,” says Dr. Kozma. Dr. Eva Ublová, the chief physician of the Central Spa run by the company Léčebné lázně Mariánské Lázně, adds that balneotherapy is prescribed in the event of repeated miscarriages. A large number of girls and young women come to the spa for preventive treatment, because they have undergone complicated operations affecting their reproductive organs that could have affected their ability to have children. These are clients both from home and abroad.

What precedes spa treatment?

There are many reasons for infertility, but there are two approaches taken by gynaecologists in connection with balneotherapy. “One group will carry out the basic examinations necessary. Then they will prescribe a plan of treatment lasting several months. If the woman still fails to become pregnant after that, they will recommend her to undergo balneotherapy. The other group, which is luckily a smaller one, will suggest sending a patient to a spa only when all the forms of treatment at home have been exhausted without success,” says Dr. Kozma about his colleagues, who provide him with their diagnosis and the results of all the tests they have carried out. “Spa specialists study these reports in detail so that they can prescribe actual spa procedures after the normal gynaecological examination, laboratory tests and sometimes ultrasound examination. The whole examination lasts about thirty minutes,” says Dr. Eva Ublová. “The prescription for the various procedures is a strictly individual matter, so that patients with what at first sight is the same diagnosis can have different plans of treatment.”

At present, between 15 – 20% of couples cannot have children without medical help. This means that infertility is diagnosed in one couple out of six. Photo: © Pliene, iStockphoto.com

The treatment is then an effective way of tuning vegetative functions, renewing hormonal balance and immunity, and removing the barriers to conception. Last but not least, the treatment helps a patient’s mental state, which is often afflicted by the unfulfilled desire to become a mother.

Frank speaking

Spa care always works as a comprehensive mechanism and individual procedures interact and complement each other. A plan of treatment can often include procedures that have opposing effects. Patients should count with a course of treatment lasting at least four weeks. The shortest course of treatment provided lasts two weeks, but it has to be when the patient is not menstruating.

“In general, we can say that we prescribe to infertile women peat baths or wraps, accompanied by special gynaecological procedures like vaginal peat tampons, vaginal irrigation (washing the vulva using mineral water and the use of what we call gynaecological gas, i.e. carbon dioxide),” says Dr. Ublová, explaining the more intimate side of balneo-gynaecology. Other recommended procedures include carbonic and pearl baths, minor hydrotherapy, gas injections, physiotherapy exercises, exercises in the pool, yoga, and classical, underwater and reflex massage.

To understand how such procedures work, let us give just two examples from the whole therapeutic spectrum. The first are peat baths, often supplemented by peat tampons. The textbook about how to work with curative mud states: “Baths and wraps that have an irritative and hyper-thermal effect are prepared from peat that has been dug and has undergone complicated technical preparation. The baths are heated to 40-42°C and the wraps to 40-44°C.” Peat maintains its temperature for a long time and transfers its accumulated heat to the patient slowly and uniformly during the time the procedure takes. Dr. Kozma adds: “Warmth is effective in reducing pain, relieves contractions in muscles of the spine and organs, speeds up the metabolism, and influences blood composition. It acts to improve the blood supply to organs in the small pelvis, which brings more oxygen and blood elements to localities affected by pathological processes, and facilitates the removal of metabolic waste, which leads to the adjustment of hormone relations.”

Spa Luhačovice / Bad Luhačovice; Photo/Foto: © martinfasanek, iStockphoto.com

Mineral water containing carbon dioxide is another natural curative resource used. Its curative effect is based on the absorption of carbon dioxide and minerals through the skin. “In the course of a bath in mineral water, the skin and subcutaneous capillaries are dilated, which is accompanied by reflectoric changes deep in the tissues. Such baths normalise the balance in the vegetative nervous system and have a marked relaxing and sedative effect. This is a cooler procedure with temperatures of 33-34°C, so we prescribe them to balance reactions to hyper-thermal procedures, or to improve the resistance of the organism as non-specific treatment of conditions associated with functional gynaecological disorders,” says Dr. Ublová about the exceptional spring water resources in Mariánské Lázně.

Thanks to its natural peat and sources of natural carbon dioxide  Mariánské Lázně has achieved a good reputation for treating gynaecological disorders.  Marienbad kann sich dank seines Naturmoores und seiner Gasquellen als Heilbad für Frauenkrankheiten profilieren.  Photo/Foto: © K45025, iStockphoto.com

Age versus ethics

One of the important factors influencing female infertility is the age of potential mothers. Women often put off having children until they are in their thirties. These days, it is no exception when a woman has her first baby just before reaching the age of forty. “I have also had patients that were over forty,” says Dr. Kozma. We asked him what he thought the maximum age should be for patients. He replied: “Such a notion could be shattered by the question as to whether I am behaving ethically and in line with my personal conviction. The reproductive ability of women varies and it would be unjust to put a set time limit on it. If a woman has an intensive desire to have a child and average life expectancy is increasing constantly, then why not try to become pregnant after reaching the age of fifty!”

Thanks to its natural peat and sources of natural carbon dioxide  Mariánské Lázně has achieved a good reputation for treating gynaecological disorders.  Marienbad kann sich dank seines Naturmoores und seiner Gasquellen als Heilbad für Frauenkrankheiten profilieren.  Photo/Foto: © K45025, iStockphoto.com

It is obvious that the ability to reproduce naturally decreases with age. And that also applies to the effectiveness of medical treatment. As opposed to assisted reproduction centres, spas cannot provide exact figures in relation to the success rate they achieve in treating infertility. Neither spa patients nor doctors have any duty to provide any feedback as to whether the spa treatment was effective or not. “We hear about the results of the treatment mainly from women that write to us remembering their stay here and from those that come back repeatedly because balneotherapy helped rid them of subjective problems,” says Dr. Josef Zoul, another specialist from Františkovy Lázně. In addition to the spas of Mariánské Lázně and Františkovy Lázně, those of Lázně Bludov, Klimkovice, Jeseník and Luhačovice also provide specialised treatment for infertility and gynaecological illnesses. Dr. Kozma that explains spas are used to prepare patients before a further attempt to stimulate the ovaries using hormones or to transfer a frozen embryo. “In the spa we endeavour to improve blood circulation to the organs in the small pelvis and get the woman into the best possible physical and mental condition.”

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Specialist cooperation: Dr. Jaroslav Kozma, Dr. Josef Zoul, Dr. Eva Ublová, Clinic of Reproductive Medicine and Gynaecology, IFV Travel Fachl. Beratung: Dr. Jaroslav Kozma, Dr. med. Josef Zoul, Dr. med. Eva Ublová, Klinik für Reproduktionsmedizin und Gynäkologie, Reisebüro IFV Travel