When IVF Isn’t Working, It May Be Time for Further Investigations

When this couple first came to see us, they had already been through years of fertility treatment and felt like IVF just wasn’t working for them.

They had undergone several rounds of IVF in the UK before travelling to Spain for further treatment. They had used donor eggs and had spent more than £100,000 trying to become parents. Despite everything they had been through, every transfer had ended in disappointment.

It’s a situation we see more often than people realise. After repeated failed cycles, it’s understandable to feel that the only option is to keep going. The focus naturally shifts to the next transfer, the next protocol or the next clinic.
Sometimes that is the right decision.

But sometimes it’s worth taking a step back first.
One of the things we believe strongly is that repeated failed IVF should prompt a conversation about whether there is anything that hasn’t yet been explored. Not because there is always a missing piece, but because every fertility journey deserves a thorough assessment before moving forward again.

When we met, we spent time looking at their story as a whole. We talked about their previous treatment, their lifestyle, their nutrition, the stress they had both been carrying for years and how the IVF medication had affected her physically and emotionally. Rather than looking for one magic answer, we looked for opportunities to better support their chances.

 

Looking Beyond Egg Quality

When donor eggs are involved, and we are dealing with repeated failed transfers, we need to be considering why. It could be something to do with implantation, lining, and factors that are getting in the way of her sustaining that pregnancy, or it could be the embryo quality or chromosomal abnormalities therefore we need to look closer at the sperm. Fertility is always about both partners.

A routine semen analysis is often reassuring because it measures sperm count, movement and shape. However, these tests don’t tell us everything about sperm health. They don’t assess factors such as sperm DNA fragmentation, which may affect fertilisation, embryo development and, in some cases, pregnancy outcomes.

That doesn’t mean every couple needs additional testing, but it does highlight why we believe both partners should be considered throughout the fertility journey. Fertility isn’t solely a female issue, and understanding the full picture can sometimes raise questions that haven’t previously been asked.

 

The Importance of Lifestyle

During our consultation, we also talked about nutrition. One habit that stood out was her daily intake of sugary fizzy drinks, including several cans of Coke each day.
There was no judgement attached to that conversation. After years of fertility treatment, many people find themselves relying on convenience, comfort or caffeine simply to get through the day.

However, lifestyle factors are one part of the fertility picture that we can influence. Research has found an association between regular consumption of sugar sweetened drinks and lower fertility in both men and women. One large prospective study published in Epidemiology reported that women who drank one or more sugar sweetened beverages each day experienced lower fertility than those who drank them less frequently. Similar associations were also observed in men.
This doesn’t mean that drinking Coca-Cola causes infertility. Fertility is far more complex than that. But when someone is trying to optimise every aspect of their health before another IVF cycle, it’s worth considering the cumulative effect of small daily habits.

Together we made gradual lifestyle changes that felt realistic and sustainable, rather than aiming for perfection overnight.

 

Supporting the Body Through the Stress of IVF

One thing that is often overlooked during fertility treatment is the emotional and physical impact of IVF itself. By the time we met, this couple had spent years living with uncertainty. Every treatment cycle brought hope, followed by disappointment. They had invested so much emotionally, physically and financially that the thought of starting another cycle felt overwhelming.

Like many women going through IVF, she was exhausted. The medication had taken its toll, her stress levels were understandably high and she no longer felt like herself.
Alongside the changes we were making to her nutrition and the further investigations being carried out by her fertility clinic, we made regular fertility reflexology a key part of her support plan.

During treatment, she came for reflexology almost every other day.
The aim wasn’t simply to help her relax, although having dedicated time to switch off was incredibly important. Each session gave her space to breathe, process what she was going through and support her body through the demands of fertility treatment.

We know that chronic stress can affect hormone signalling through the hypothalamic pituitary ovarian (HPO) axis, which plays an important role in regulating the menstrual cycle and ovulation. Many women tell us they feel calmer, sleep better and feel more able to cope with treatment after regular fertility reflexology sessions, which we do from our clinic in Wokingham, Berkshire.

For this client, reflexology wasn’t a replacement for IVF. It was one part of a much wider plan that included medical treatment, lifestyle changes, nutritional support and investigating possible underlying factors that hadn’t previously been explored.

 

Why We Discussed Natural Killer Cells

After another unsuccessful embryo transfer, I suggested that it might be worth discussing natural killer cell testing with their fertility specialist in Spain.
Natural killer cells are a type of white blood cell that play an important role in the immune system by helping the body respond to infections and abnormal cells. Over the years, researchers have explored whether abnormal activity of these cells may play a role in recurrent miscarriage or repeated implantation failure in some women.
This is an area of fertility medicine where opinions differ, and it isn’t a test that is recommended for everyone. However, for some couples who have experienced repeated implantation failure without a clear explanation, a fertility consultant may decide that further immune investigations are appropriate.

The testing carried out through their Spanish clinic identified elevated natural killer cell activity. Their fertility specialist recommended treatment, while I continued to support her alongside her medical care with regular fertility reflexology, dietary improvements and emotional support throughout treatment.
It’s important to say that fertility reflexology doesn’t treat natural killer cells, nor can it guarantee pregnancy. My role is to support the whole person through what is often one of the most physically and emotionally demanding experiences of their life.

 

What Are Natural Killer Cells?

Natural killer (NK) cells are a type of white blood cell that form part of your immune system. Their main role is to recognise and destroy cells that are infected by viruses or have become abnormal, helping to protect your body from illness.
When it comes to fertility, researchers have been investigating whether abnormal numbers or activity of NK cells could affect implantation or increase the risk of recurrent miscarriage in some women.

This is still an area of ongoing research, and experts don’t all agree on the role NK cells play in fertility. However, for some people who have experienced repeated implantation failure or recurrent pregnancy loss, a fertility specialist may decide that further immune investigations are appropriate. However in our experience here, we have seen many scenarios where identifying and treating NK cells has resulted in a successful pregnancy. For this couple, after several unsuccessful IVF cycles using donor eggs, it was one of the questions we felt was worth exploring.

 

How Do I Know If I Have Elevated Natural Killer Cells?

Unfortunately, there are no specific symptoms that tell you whether you have elevated natural killer cell activity. Most women who are investigated for NK cells feel completely well. The possibility is usually considered because of their fertility history rather than because of any physical symptoms.

Your fertility specialist may discuss immune testing if you have experienced:

• repeated failed embryo transfers
• recurrent miscarriage
• good quality embryos that repeatedly fail to implant
• unexplained infertility after appropriate investigations

It is important to remember that these experiences can have many different causes, and NK cells are only one possible area that may be explored.

 

How Are Natural Killer Cells Tested?

If your fertility specialist feels immune testing may be appropriate, there are a number of different ways NK cells can be assessed.
Some clinics begin with a blood test to measure the number and activity of natural killer cells circulating in the bloodstream.

Other specialists may recommend more detailed immune investigations or, in certain situations, an endometrial biopsy. This involves taking a small sample of the lining of the uterus to assess the immune cells present where implantation takes place.

Not every fertility clinic offers these tests routinely, particularly in the UK, and approaches vary considerably between clinics and countries.
In this case, testing was arranged through the couple’s fertility clinic in Spain following another unsuccessful embryo transfer.

 

What Happens If Natural Killer Cells Are Found?

If testing suggests elevated NK cell activity, your fertility consultant will discuss whether treatment is appropriate for your individual circumstances.
Treatment varies between clinics and may include medications that help to modify the immune response around the time of embryo transfer. These treatments are prescribed and monitored by a fertility specialist and are not suitable or necessary for everyone.
The decision to treat is always based on a person’s full clinical history rather than the test result alone.

 

Can Fertility Reflexology Treat Natural Killer Cells?

No. Fertility reflexology does not treat natural killer cells, and it isn’t a replacement for medical care. Our role is to support your wellbeing throughout your fertility journey. Many clients tell us that regular fertility reflexology helps them feel calmer, sleep better and cope more effectively with the emotional and physical demands of IVF. On top of that, our fertility coaching calls allow us to investigate to see if there are some areas that haven’t yet been explored. So we can help you holistically during your fertility journey and treatment.

 

Success at last with twin girls

Several months later, I received a message. Amongst many others that I still treasure.
It arrived less than 24 hours after the birth of their twin girls.

“From the very bottom of our hearts, thank you for making us parents ❤️
Without your continued and unwavering support and approach, this would never have happened for us. We dreamt for all these years of one baby and yet we ended up with two 💕💕

Your reflexology, with a sprinkle of Reiki, changed the path for us and without you we would not be here today with our two baby girls. It’s not yet been 24 hours and we still cannot believe this is our reality.
Forever indebted to you.
All our love.”

I never take messages like this for granted.
Not because I believe I have all the answers, but because they remind me how important it is to listen carefully, to ask questions and to look beyond the obvious when someone has experienced repeated disappointment.

Every fertility journey is different. Sometimes further investigations don’t reveal anything new. Sometimes they do. What matters is that couples feel they have explored every appropriate avenue before moving on to the next stage of treatment.

If you’re trying to conceive and have experienced repeated failed IVF cycles, you don’t necessarily need more treatment straight away. Sometimes what you need first is someone to step back with you, look at the whole picture and ask whether anything may have been overlooked.

That, more than anything else, is the approach we bring to every consultation.