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Fertility – How We Can Help Couples with Functional Infertility

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The journey toward having a baby can unexpectedly involve a long period of waiting and uncertainty. According to reproductive health experts, infertility is becoming an increasingly common problem for couples, often including young people. Even though the results of gynecological or andrological examinations are within normal limits, many couples suddenly find themselves facing a diagnosis of functional infertility—that is, infertility without a clear cause. It is precisely in these cases that physical therapy focused on the pelvic floor and overall body relaxation can be very helpful.

Physical Therapy and Its Impact on Fertility

Physical therapy is often associated with rehabilitation following injuries or surgeries, but it is becoming increasingly clear that it can also play an important role in treating functional infertility. Here at IntimFyzio, we work with clients who have various pelvic floor issues, including fertility problems. Functional infertility can be caused by improper pelvic floor muscle tone or breathing problems, which lead to insufficient blood flow and oxygenation of the reproductive organs, thereby reducing their functionality.

Katka Hanuliaková, an expert in intimate physical therapy, explains: “Many couples who come to us have already undergone a wide range of tests, but the results are within normal limits. However, it’s important to know that if the pelvic floor muscles aren’t functioning properly, they can literally block the natural bodily processes that are crucial for conception. So even if everything is ‘fine,’ the problem may actually lie inimproper muscle tone or incorrect breathing.”

How can pelvic floor problems affect fertility?

The pelvic floor is a group of muscles that plays a key role in supporting the organs in the pelvic region and ensuring their proper function. If the pelvic floor muscles are too tense or, conversely, too weak, this can cause problems with circulation and oxygen supply, which can impair the function of the reproductive organs. Proper functioning of the reproductive organs is also significantly influenced by quality breathing. If breathing is shallow and irregular, the organs in the pelvic region receive less oxygen, which negatively affects their ability to perform all their functions. Proper breathing techniques contribute to the nourishment of the reproductive organs and to the harmonization of the hormonal systems in both women and men.

Physical Therapy Approaches to Functional Infertility

Physical therapy techniques aimed at improving fertility include working on proper breathing, as well as exercises to relax and strengthen the pelvic floor. At our center, we view intimate physical therapy as part of holistic care for the body, mind, and emotions. Our clients often feel a sense of relaxation after just a few sessions, as they begin to be more attuned to their bodies and learn to release excess tension and stress. “This can have a positive impact on their fertility, as the body functions more harmoniously as a whole,” says Katka Hanuliaková. With regular physical therapy, it is possible to improve oxygenation and blood flow to the pelvic region, which can increase the chances of conception.



When should you visit us?

If you’ve been trying to conceive for a long time and all your test results are normal, seeing a physical therapist who specializes in the pelvic floor may be a good step to take. Physical therapy offers a different perspective on fertility and can help identify and alleviate problems that conventional methods may miss. Katka Hanuliaková concludes by emphasizing: “It’s often the case that a physical therapy approach is the missing link that helps a couple achieve their dream of starting a family. Every body is different and has its own specific needs—our role is to help the body find harmony so that it is ready and able to conceive.” With regular physical therapy, it is possible to improve oxygenation and blood flow to the pelvic area, which can increase the chances of getting pregnant.

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The body does not need to be fixed. It needs to be understood.

I am a woman, wife, mother and physiotherapist. Over the years of practice, I have realised that health does not come only from eliminating symptoms or solving a specific problem. Real change comes when a person begins to better understand themselves, their body, and the way they live their life.

It was this idea that led me to create the space you know today as ToBe – a place where different areas of expertise, perspectives, and approaches to health are interconnected. A place that does not see a person only through a diagnosis or individual symptoms, but as a unique whole.

My professional journey began in physiotherapy and the musculoskeletal system. Over time, clients and their stories gradually led me deeper – from working with the body through the pelvic floor to understanding the meaning of emotions, the psyche, and the functioning of the nervous system. Today, I see the body as the bearer of a person’s story, and therapy as a space where we can get to know that story, understand it, and support its natural process of change.

How I work

Years of practice have taught me to slow down. To listen more. To place less emphasis on performance, results, or quick change.

In therapy, I strive to create a safe space where clients can become more aware of their bodies, their needs, and the connections between what they are experiencing and what is happening on a physical level. I don’t focus only on symptoms; I also look for their possible causes and the context in which they arise.

Over the years, I have become increasingly aware of how closely the body, mind, and nervous system are connected. This is why I naturally integrate a psychosomatic perspective and the principles of nervous system regulation into my work – gently, clearly, and always with respect for where each client is in their own process.

I believe the body has a remarkable capacity for healing and renewal. Sometimes it doesn’t need more pressure — it needs understanding, a sense of safety, and the right conditions to begin functioning in a different way.

What I can help you with

In my practice, I specialise mainly in:

  • urogynecological physiotherapy
  • pelvic floor dysfunction
  • incontinence
  • painful conditions after childbirth
  • preparation for childbirth and postpartum recovery
  • painful menstruation
  • pain during sexual intercourse
  • functional disorders of the musculoskeletal system
  • chronic pain without an organic cause
  • unintegrated scars
  • psychosomatic connections of health problems
  • regulation of the nervous system

Methods and approaches I use

In my work, I connect physiotherapy with knowledge from psychosomatics, work with the nervous system, and a holistic therapeutic approach. I mainly use:

  • urogynecological physiotherapy
  • pelvic floor therapy
  • diagnosis and therapy of functional disorders of the musculoskeletal system
  • visceral manipulation
  • osteopathic principles
  • craniosacral therapy
  • psychosomatic approach in physiotherapy
  • principles of nervous system regulation
  • knowledge from Somatic Experiencing® training

In therapy, I combine professional knowledge with a sensitive perception of the person and their story. My goal is not only to relieve the problem, but to support the client in better understanding themselves and their body.

ToBe – the concept

ToBe grew naturally out of the original IntimFyzio centre. Over time, I increasingly felt the need to bring different areas of expertise together and create a place where a person does not have to be divided into separate parts.

Today, ToBe is a multidisciplinary space where physiotherapy, psychology, psychotherapy, women’s health, traditional Chinese medicine, work with the nervous system, and other approaches come together – united by a common idea: to see a person in their entirety and create the conditions for health, growth, and a deeper connection with oneself.

Education and professional development

I studied physiotherapy at the Faculty of Medicine of Comenius University in Bratislava, and completed my master’s degree at the University of Brighton in the United Kingdom.

I have completed a specialisation in functional and structural disorders of the musculoskeletal system at the Slovak Medical University in Bratislava. I hold a licence for independent medical practice and am a member of the Slovak Chamber of Physiotherapists.

Training that has significantly shaped my therapeutic approach

  • Somatic Experiencing® (currently in training, Lilian Troost)
  • Psychosomatic approach in physiotherapy (CKP Edu, Prague)
  • Visceral manipulation and osteopathic approach (Inge Schuermans, MSc)
  • Birth trauma in physiotherapy and self-regulation tools in client practice (Mgr. Radka Tomášková)
  • Holistic approach to scar and pelvic floor therapy (PhDr. Michaela Prokešová, PhD.)
  • Traditional care for women and mothers (Angelina Miranda Martinez)
  • Osteopathic approach in pregnancy and gynaecological dysfunctions (Inge Schuermans, Jory Paul)
  • Ludmila Mojžišová method (Mgr. Jana Jedličková)
  • Physiotherapy of pelvic floor dysfunction and urinary incontinence (Prof. Magdaléna Hágovská, Mgr. Zuzana Woleková)
  • Craniosacral therapy (Mgr. Helena Toušková, Upledger Institute)
  • Certified DNS Therapist Diploma (Prof. Pavel Kolář)
  • Diagnosis and Therapy of Functional Disorders of the Musculoskeletal System (Eva Janíková)
  • Stott Pilates (Jitka Kadish)

I believe health is not a goal to be achieved. It is a relationship we build with ourselves, our bodies, and our lives – and it is a journey I love to accompany my clients on.