The Bondi Protocol: Revolutionary Treatment for Immune-Related Fertility Issues
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| Published: March 10, 2026 Last reviewed:March 10, 2026 Reviewed by: A/Prof Gavin Sacks - Group Medical Director and Fertility Specialist Genea |
If you've experienced repeated IVF failure or recurrent miscarriage despite normal test results, the Bondi Protocol could offer the answers you've been searching for. This innovative immune therapy, developed by A/Prof Gavin Sacks at Genea, has demonstrated remarkable results: women with high NK cell activity achieved live birth rates over four times higher compared with standard protocols.
What is the Bondi Protocol?
The Bondi Protocol is an innovative treatment developed by A/Prof Gavin Sacks based on his research into immune causes of recurrent miscarriage and repeated IVF failure. This immune therapy specifically targets women whose fertility challenges result from an overactive immune response, particularly elevated NK cell activity.
The treatment involves a combination of two common and inexpensive medications: prednisolone (a corticosteroid) and Clexane (enoxaparin, a blood thinner). Together, these medications suppress the overactive immune system in women with high NK cell activity, creating a more receptive environment for embryo implantation and early pregnancy development.
Who is the Bondi Protocol for?
Most cases of miscarriage and IVF failure relate to problems with the embryo that occur at random. In cases of repeated miscarriage or IVF failure, testing may reveal issues with genetics, the uterus, hormones, antibody or clotting systems, or sperm quality.
However, sometimes these tests come back normal. In these cases, further testing of the mother's immune system may reveal a potential issue affecting her ability to achieve a successful pregnancy.
You may be a candidate for The Bondi Protocol if you have:
- Repeated IVF failure where embryos fail to implant despite good quality
- Recurrent miscarriage (two or more losses)
- Normal standard fertility tests with no obvious explanation
- Elevated NK cell activity confirmed through blood testing
The Bondi Protocol won't help if:
- Embryo quality is the primary issue
- Structural uterine problems haven't been addressed
- Male factor infertility is the sole cause
Proper NK cell testing is essential to determine whether immune therapy is appropriate for your situation. Learn more about NK cells and pregnancy.
How the treatment works
The treatment is taken daily by injection, starting at the beginning of an IVF cycle, or as soon as a pregnancy is confirmed, and is continued until at least the 12th week of pregnancy.
For IVF cycles: Begin medications at the start of your cycle, continuing through embryo transfer and into early pregnancy.
For natural conception: Start the protocol as soon as pregnancy is confirmed through a positive test.
Medications:
- Prednisolone: Oral tablets taken daily
- Clexane: Subcutaneous injection (under the skin) administered daily, typically in the abdomen or thigh
Both prednisolone and Clexane are commonly used in early pregnancy and have an established safety profile. However, it is important that women taking the Bondi Protocol are closely monitored by a fertility specialist.
What to expect: Side effects and safety
Common side effects
Women on this treatment may experience some minor side effects, including:
- Poor sleep (particularly if prednisolone is taken late in the day)
- Increased fluid retention and mild swelling
- Mild pain or bruising at injection sites
- Occasional mood changes
These side effects are generally mild and manageable. Most women find the potential benefits far outweigh these temporary inconveniences.
Safety for your baby
The only potential side effect for the baby is a less than 0.5% chance of having a cleft palate (around 3 in 1,000 babies). To put this in perspective, the background risk in the general population is approximately 1 in 1,500 babies. Both medications have been extensively studied and are commonly used during pregnancy for various medical conditions.
The research: Understanding success rates
A recent study conducted by A/Prof Sacks found that for women with high NK cell activity levels, live birth rates were over four times higher when the Bondi Protocol was used (28%), compared with standard protocols (approximately 7% per cycle).¹
What these numbers mean for you
A 28% live birth rate per cycle represents significant hope, but it's important to maintain realistic expectations:
- Not every cycle will result in pregnancy
- Some women may require multiple cycles
- Individual factors (age, embryo quality) still influence outcomes
- The protocol addresses immune dysfunction but doesn't eliminate all fertility challenges
For women who have experienced repeated failure with standard protocols, these results represent a dramatic improvement in chances of success.
Why choose Genea for the Bondi Protocol
A/Prof Gavin Sacks' pioneering expertise: A/Prof Sacks developed the Bondi Protocol, introduced NK cell testing to Australia, and continues to refine treatment approaches based on ongoing research. Accessing the expertise of the physician who pioneered this treatment ensures accurate assessment and optimal protocol customisation.
Comprehensive support: The Bondi Protocol integrates seamlessly with thorough diagnostic testing, personalised treatment planning, expert monitoring, fertility counselling, and coordinated care across your entire team.
Proven outcomes: Beyond published research, Genea's real-world experience demonstrates consistent success for appropriately selected patients.
Your next steps
If you're experiencing recurrent miscarriage or repeated IVF failure and would like to consult A/Prof Sacks about whether the Bondi Protocol might be appropriate for you, our team is here to help.
Your journey begins with comprehensive assessment including:
- Detailed review of your fertility history
- NK cell testing if not already completed
- Assessment of other potential contributing factors
- Personalised treatment planning if the protocol is appropriate
You deserve to understand why your fertility journey has been challenging. You deserve treatment that addresses the actual cause of your difficulties rather than simply repeating the same approach and hoping for different results.
Contact our Fertility Concierge today to book an appointment with A/Prof Gavin Sacks. Let's explore whether immune factors are affecting your fertility and create a personalised treatment plan designed for your specific needs.
Disclaimer: Please note that this is a Genea Group blog and as such information may not be relevant for all clinics. We advise that you consult clinics directly for further information.
References
Sacks G & Zhang J. Prednisolone and enoxaparin (clexane) therapy (‘the Bondi protocol’) for repeated IVF failure. Am J Reprod Immunol. 2022;88(5):e13616. doi: 10.1111/aji.13616.
FAQs
The Bondi Protocol is an immune therapy developed by Genea Group Medical Director and Fertility Specialist, A/Prof Gavin Sacks, using prednisolone and Clexane to suppress overactive immune systems in women with elevated NK cell activity. Research shows over four times higher live birth rates compared to standard protocols for women with this specific immune issue.
You're a potential candidate if you've experienced recurrent miscarriage or repeated IVF failure with normal standard fertility tests, and NK cell testing confirms elevated activity. Proper testing is essential to determine if immune therapy is appropriate for your situation.
A/Prof Sacks' research found women with high NK cell activity achieved a 28% live birth rate using the Bondi Protocol, compared to approximately 7% with standard protocols. Individual results vary based on age, embryo quality, and other health factors.
Common side effects include poor sleep, mild fluid retention, and injection site discomfort. For babies, there is a less than 0.5% chance (3 in 1,000) of cleft palate, compared to the background risk of 1 in 1,500. Both medications have established safety profiles when monitored by a specialist.
Treatment is taken daily from the start of your IVF cycle or confirmation of pregnancy, continuing until at least the 12th week of pregnancy when the placenta is well-established.
No fertility treatment can guarantee pregnancy. The protocol significantly improves success rates for women with elevated NK cell activity, but individual results vary and some women may need multiple cycles.
The protocol uses common, inexpensive medications, making it accessible. Costs include medications, specialist monitoring, and standard IVF cycle costs if applicable. Our Fertility Concierge can provide specific information including potential Medicare rebates and payment plans.
Yes, if you have elevated NK cells and are attempting natural conception, the protocol can start when pregnancy is confirmed. Close monitoring by a fertility specialist is essential throughout treatment.
Contact our Fertility Concierge to schedule a consultation or you can book directly with him via Genea here. You'll discuss your fertility history, review previous testing, and determine whether the Bondi Protocol is appropriate for your situation.