I work with couples whose fertility picture is more complicated than they have been told, and look for what standard testing has missed.
By the time most couples reach this practice, they have already been on a long journey.
One or two years of trying. Sometimes a round of IVF, or two, or three. Sometimes a miscarriage, or several. Tens of thousands of pounds spent. Tests that come back labelled "normal" while the experience tells them something else.
They arrive carrying a persistent sense that the picture is more complicated than they have been told.
That sense is what I work with.
That is the work I do.
One or more cycles that didn't result in pregnancy.
Your ovaries didn't respond as the protocol expected.
Cycles where good-quality embryos could not be obtained.
Good-quality embryos that stopped developing or failed to implant.
One or more pregnancies lost, often early.
Low motility or morphology, DNA fragmentation or sperm microbiome dysbiosis — even when standard semen analysis reads as normal.
These are the pictures most often gathered under "unexplained infertility".
They are rarely truly unexplained — they are underinvestigated.
Real outcomes from complex fertility cases, recurrent loss, and previously unexplained infertility.
"After three recurrent losses and being told everything was 'normal', Inna helped us find the real root cause. Her functional approach uncovered things our clinic never even tested for. We are now 24 weeks pregnant with our healthy baby boy."
IVF Success after Recurrent Loss
"The male factor testing and protocol was a game-changer for us. Six months of targeted preparation focusing on the microbiome completely changed our outcomes. I can't recommend her methodology enough."
Male Factor Preparation
"Inna is a true detective. She genuinely listens, investigates with absolute precision, and creates protocols that make sense. Her guidance gave us clarity when we felt completely lost in the fertility world."
Complex Infertility Journey
Registered Naturopath, Nutritional Therapist, Medical Herbalist (MSc) — in full-time clinical practice since 2017.
For more than a decade I have built one practice, around one focus: investigating what conventional fertility care does not screen for in cases where standard tests come back unremarkable.
My training is unusual for a fertility practitioner: a Master of Science in Medical Herbalism with Distinction, a Postgraduate Diploma in Functional Nutrition and an MBA, alongside full registration with the General Naturopathic Council. That combination lets me read advanced functional lab data, prepare herbal protocols that are not available off a shelf and stay on top of complex cases over many months.
During one ten-month period of particular focus on the reproductive microbiome of both partners, I held more than five hundred fertility consultations. That depth of work continues to shape how I read every case that reaches me now.
I trained under Dr Leah Hechtman in Advanced Fertility and Advanced Gynaecology, completed the Advanced Fertility Mentorship Program with Rhiannon Hardingham ND — one of Australia's leading fertility naturopaths — and mentored by Naava Carman, alongside several other prominent teachers in the field. I am certified in Nutrigenomics (Lifecode Gx), Reproductive (Male) Stealth Pathogens and Biotoxin Illness. I undertake roughly three hundred hours of continuing professional development every year, equivalent to a full university year of study. I contributed the chapter on medicinal plants for mental wellbeing to Dorling Kindersley's Neal's Yard Mental Wellness Companion (2021).
I do not take cases I cannot work with properly. That is part of why this practice has grown the way it has: slowly, through referrals from fertility practitioners and previous clients who told someone else. One couple at a time.
If yours is one I can work with, you will know it within the first thirty minutes of our Introductory Review.
— Inna
Fertility consultations focused on the reproductive microbiome
Average length of work with a couple, both partners screened and supported
Naturopath · Nutritional Therapist · Medical Herbalist (MSc, Distinction)
Neal's Yard Mental Wellness Companion · Dorling Kindersley 2021
Full-time clinical practice since 2017, built upon seven years of supervised practice in the University Herbal Medicine Clinic (2010–2017). The functional approach requires rigorous academic training, extensive clinical experience, and continuous professional accountability.
Qualification accredited by National Institute of Medical Herbalists, CPP, and EHTPA.
Institute for Optimal Nutrition and University of Portsmouth.
Registered with the General Naturopathic Council (GNC).
Registered member of the Association of Naturopathic Practitioners.
The work in this practice — particularly on the male reproductive microbiome — is taught to other practitioners and referenced by fertility practitioners across the UK.
"Inna's course was truly next level — the most comprehensive I've come across on the male reproductive microbiome. Her depth of knowledge and expertise are unparalleled, and it's clear she's a thought leader in this field."
Acupuncturist · @clairenortonacupuncture
"A fantastic webinar with Inna last night — learning how microbes impact the health of sperm, and consequently the health of offspring."
Women's Health Practitioner · @jessica_womenshealth
"Thank you for your excellent webinar — really interesting. I am clued up on female microbiomes and the impact on their fertility, but didn't know anything about the male side, so this is hugely interesting."
Practitioner attending Inna's training
Quotes published with permission from each practitioner.
Three principles that hold every case I take on.
Every recommendation is anchored to functional laboratory data — for both partners. Without that, every protocol is a guess in a more expensive wrapper. I do not work without testing, and I will not suggest I can.
Fertility is a shared ecosystem. The reproductive microbiome — vaginal, uterine, seminal — is rarely investigated in standard care. In my practice, both partners are screened, and both are supported. There is no other way to do this work properly.
From your first consultation through conception, pregnancy and postpartum recovery, the same practitioner holds the relationship. Continuity comes from how complex cases are kept safe over twelve, eighteen, twenty-four months of work.
When standard fertility care says "unexplained", this is where I begin.
For her: vaginal and uterine microbiome — including Lactobacillus levels, Gardnerella and other pathogens that disrupt implantation.
For him: seminal microbiome — almost never investigated in standard fertility care, yet often the driver of recurrent uterine inflammation. This was the focus of more than five hundred consultations in my practice.
The World Health Organisation recognises TORCH — Toxoplasmosis, Other (including Varicella and Epstein-Barr), Cytomegalovirus and Herpes. Standard fertility care often does not screen TORCH at the cellular immunity level — where reactivation patterns become visible. I look further: Chlamydia, Varicella, Mycoplasma, Lyme and its co-infections.
Cytokine ratios, NK cell activity, mucosal inflammation, subclinical autoimmunity. The immune signals that decide whether the body welcomes or rejects an otherwise viable embryo. Investigated by referral.
Heavy metals, mycotoxins from mould, environmental endocrine disruptors. Often-overlooked contributors to mitochondrial dysfunction and hormone disruption — and to why a previously responsive body has stopped responding.
Subclinical thyroid dysregulation, methylation imbalance — leading to impaired DNA replication, luteal phase insufficiency due to insufficient progesterone, insulin sensitivity, pre-diabetes. Looked into the specifics of your case — not against population reference ranges.
Functional medicine stool analysis. The gut microbiome shapes systemic inflammation, hormone metabolism and nutrient absorption — all of which directly affect fertility. Gut dysbiosis is upstream of many conditions clients are told have no clear cause.
Comprehensive food sensitivity panels and metabolomics — a panel that maps thousands of metabolic markers at once and reveals dysfunction in pathways before standard bloods do. Especially valuable in cases of fatigue, brain fog and unexplained inflammation alongside fertility difficulties.
Lifecode Gx panels — looking into your specific genetic profile across methylation, hormone processing, detoxification, oxidative stress response. The same nutrient at the same dose works differently for different bodies. Yours is one of them.
Mycotoxins and environmental toxins affect both partners — which is why we test both. They can disrupt hormone balance, egg quality, sperm DNA integrity, testosterone balance, mitochondrial function, and inflammation in either partner. Environmental exposure is often higher in men through industrial or construction work, workshops, dust or mould in workplaces. Rarely investigated in standard fertility workups, yet often the missing piece in male factor cases. Testing both partners also reveals shared exposures at home or workplace.
In standard fertility care, the male partner is asked to provide a semen sample. Count, motility, morphology. That is usually where his investigation ends. In this practice, it is where it begins.
I screen the seminal microbiome with biofilm-buster preparation, without which the test reads as a false negative and the bacteria driving uterine inflammation never surface. I screen for the same TORCH and beyond pathogens that I run for the female partner. I look at sperm DNA fragmentation, oxidative stress markers, hormonal balance and methylation — because half of the embryo is his, and the work of preparing that half takes the same six months that egg quality preparation takes.
Both partners screened. Both partners supported. Half of the embryo is his, and so is half of the work.
Read the full Male Fertility pageWhere specialised expertise is needed — reproductive immunology, MRI, advanced ultrasound — I work with a referral network of trusted clinicians. Time-sensitive cases are coordinated accordingly.
What is investigated, and what is not. A side-by-side comparison of how standard fertility care approaches investigation, and how my practice extends it. Useful if you are deciding whether deeper testing is worth pursuing.
| Aspect investigated | Standard fertility care | My practice |
|---|---|---|
| Female reproductive microbiome | Rarely tested beyond basic swabs | Full vaginal and uterine microbiome panels — Lactobacillus levels, Gardnerella, other pathogens |
| Male seminal microbiome | Not investigated | Full seminal microbiome with biofilm-buster preparation for accurate results |
| Latent infections (TORCH+) | Basic serology if requested | Cellular immunity panels for both partners — Chlamydia, Varicella, Mycoplasma, Epstein-Barr, Lyme and its co-infections |
| Reproductive immunology | Rarely investigated in standard workups | Cytokine ratios, NK cell activity, mucosal inflammation, subclinical autoimmunity (by referral) |
| Sperm DNA fragmentation | Not in standard semen analysis | Investigated alongside oxidative stress markers and morphology |
| Toxic load & environment | Not investigated | Heavy metals, mycotoxins from mould, environmental endocrine disruptors |
| Endocrine terrain | TSH, basic hormones | Subclinical thyroid dysregulation, methylation imbalance leading to impaired DNA replication, luteal phase insufficiency due to insufficient progesterone, insulin sensitivity, pre-diabetes |
| Comprehensive stool analysis | Not part of standard workup | Functional medicine stool analysis with gut microbiome profiling |
| Food sensitivity & metabolomics | Not part of standard workup | Comprehensive panels mapping thousands of metabolic markers |
| Environmental toxins & mycotoxins (men) | Not investigated | Toxic element + mycotoxin panel — especially for male partners with environmental exposure |
| Nutrigenomics | Not part of standard workup | Lifecode Gx panels — looking into your specific genetic profile |
| Continuity of care | Different practitioner at each stage | One practitioner from first consultation through pregnancy and postpartum |
Three anonymised patterns — illustrating the kind of complexity I see in this practice. Written so you can recognise the shape of your situation, or recognise that it sits outside the scope of what I do.
Several years of trying. One natural conception, ended in early miscarriage. Two IVF cycles since — first cancelled at egg collection for poor response, second produced one viable embryo and a biochemical pregnancy. Standard NHS and IVF clinic workup unremarkable.
Undiagnosed autoimmune thyroid disease. Disrupted uterine microbiome with indications of pelvic inflammation. Latent CMV reactivation in both partners. On the male side, poor sperm morphology and high DNA fragmentation.
A multi-month protocol with retest at the end. The next IVF cycle worked, and the pregnancy is progressing.
“I wanted someone who would stop telling me my eggs were old and actually look for what was going on.”
Multiple IVF cycles privately. Repeated failed implantations and one clinical loss in early pregnancy. Tens of thousands of pounds spent. Beginning to consider donor egg.
On the female side: high T-helper cytokine ratio, vaginal microbiome dysbiosis, positive markers on a urinary mycotoxin panel, reactivated Varicella and chronic Chlamydia. On the male side: borderline-low testosterone, poor sperm morphology, reactivated Varicella, chronic Chlamydia and active Lyme disease.
An extended protocol with overlapping environmental remediation for the mould exposure. One IVF round, with embryo testing; a successful frozen embryo transfer the following year.
“We were ready to give up on our own eggs. We are glad we gave it one more proper look.”
Solo by choice. One IUI cycle with donor sperm, no implantation. Considering moving to IVF, possibly with donor eggs. Wants to know what she can address before spending further.
Subclinical hypothyroidism with antibodies that had never been tested. Pathogen-related iron imbalance — low iron alongside high ferritin. Significantly disrupted reproductive microbiome. Toxic and mycotoxin load from previous occupational exposure not investigated.
A multi-month protocol before IVF. Pregnancy on the first IVF cycle with her own oocytes following protocol completion.
“It felt like the first time someone took my case as seriously as I did.”
Anonymised patterns — illustrative of complexity seen in this practice. All identifying details have been fully changed.
Nine steps. Each one with a clear purpose, deliverable and investment. You can step away at any point — after the Introductory Review or after the Comprehensive Consultations. The full lifecycle is for couples who want one practitioner across the whole journey.
| # | Step | Duration | Investment |
|---|---|---|---|
| 1 | Introductory Fertility Review for a couple | 30 minutes | £200 |
| 2 | Advanced Functional Testing both partners | 4–6 weeks | From £3,000 / person + £300 admin |
| 3 | Comprehensive Fertility Consultations each partner | 75 / 45 min | £660 / couple |
| 4 | Monthly Support for a couple | 6–12 months | £300 / month |
| 5 | Selective Retest | Around month 4 | Lab fees only |
| 6 | Major Re-test & Exit Review | End of programme | Lab fees + £300 |
| 7 | Pregnancy Support | 9 months | £300 / month |
| 8 | Postpartum Support | 6 months | £300 / month |
| 9 | Next Pregnancy Preparation | Individually decided | £300 / month |
Functional lab fees are paid directly to the laboratories. Total investment in lab testing across the journey is typically £4,000–£6,000 per couple, depending on case complexity.
During Step 4, an optional clinical messaging service is available for an additional £200 per month, with a 48-hour weekday response standard for relevant questions.
Appointments can be rescheduled with at least 48 hours' notice. Cancellations made less than 24 hours before the appointment are non-refundable.
All prices are subject to VAT at the applicable rate of 20%, it will be automatically added at booking.
I work with both partners as a clinical principle, not a preference. Fertility is a shared ecosystem, and the screening and the protocol depend on both being involved. If one partner is unwilling to take part, I cannot do the work properly. I will tell you that at the Introductory Review rather than weeks into a protocol.
Five hidden reasons "perfect-grade" embryos fail to implant. Discover the biological factors standard IVF protocols often miss.
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Perspectives on advanced functional testing, preparing the terrain for conception, and uncovering the hidden factors of complex fertility cases.
Standard semen analysis measures count, morphology, and motility. It completely misses the sperm microbiome and DNA fragmentation—factors causing over half of 'unexplained' cases.
The uterus is not a sterile environment. A disruptive uterine microbiome can trigger silent inflammation, turning a theoretically perfect embryo transfer into a recurrent loss.
Standard fertility tests evaluate the basics, but recurrent loss and failed IVF often stem from cellular immunity, reproductive immunology, and toxic load. Here is what functional testing reveals.
Inna Duckworth