The Bondi Protocol

The Bondi protocol is a simple and inexpensive treatment for women who may have an immune problem causing either repeated IVF failure or repeated miscarriages. It has been developed by Dr Sacks over the last 8 years, and evaluation and research trials are still ongoing.

While anyone would be frustrated when IVF fails or when a pregnancy is lost with a miscarriage, most failures and losses are actually due to abnormalities in the embryos. And those abnormalities are almost always apparently random events in nature. There are tests that can be done on the mothers womb, her genetic background, hormones, antibody and clotting systems, and on the fathers genetic background and his sperm quality (see repeated IVF failure). When those tests are normal, and there appears to be no other cause for the loss or IVF failure, further testing of the mothers immune system may identify a potential problem (see NK cells).

When there is evidence of high NK cell activity, immune therapy may improve success rates. There are many regimes and alternatives to achieve this (eg. Prednisolone, intralipid, IVIG, humira). The costs and side effects vary considerably, but all treatments are designed to achieve the same thing, and so far none has been shown to be superior to any other. The Bondi protocol is a combination of prednisolone and clexane, taken from the start of an IVF cycle or as soon as a pregnancy has been diagnosed. It is continued until at least 12 weeks gestation.

This therapy has some minor side effects for the mother (poor sleep, increased fluid retention, mildly painful injections) and the only known potential side effect for the baby is a theoretical risk of cleft palate (approx. 3 per 1000, or less than 0.5%). The advantages are relatively low cost and ease of administration, and many years of experience of the use of these drugs in early pregnancy. However, the best results are when this treatment is targeted to those women who have high NK cell activity (see research articles below). It is important that women taking the Bondi protocol are closely monitored by their specialist.